Patient Referral Form

Thank you from all of us at Colorado Eye Institute for your trust in us! Below is our online patient referral form. We look forward to working together to provide exceptional care!

If you’d prefer to send a fax or an email, please click here.

Fax or E-mail a Referral Request Form

If you prefer to continue to fax or e-mail referrals, please download the attached Patient Referral Form, fill out all fields, and send it via the following information.

Fax: (719) 282-1247

E-mail: Kreed@eyescolorado.com

Patient Referral Form

Fax or E-mail a Referral Request Form

Schedule your appointment today