We can serve you best, if you fill out a Health History form and mail or fax it to us prior to the visit for our review.
If this is not possible, please bring it with you to your appointment. We suggest patients also bring a copy of their forms and records in addition to mailing or faxing a copy. Download/Print the Health History form >
General Surgery Consultation Suite
Attn: Colorectal Surgery Program
200 UCLA Medical Plaza, Suite 214
Los Angeles, CA
Colorectal Surgery Program
A complete set of medical information will facilitate your care and save you considerable amounts of time.
Request an appointment by phone: 310-794-7788
For your convenience, you may also use our online appointment request form.