Consultation Request Form

If you are a physician and would like to refer a patient to Shane Retina, please fill out and submit this form.

The Ophthalmologists at Shane Retina specialize in Macular Degeneration, Flashes and Floaters, Intravitreal Eye Injections, and many more conditions of the retina. We treat patients from the Sarasota, Bradenton, Lakewood Ranch, Venice, Englewood and North Port areas of Florida.