For Healthcare Professionals

How to Refer a Patient

By Phone

• UCLA Physician Referral - 1-800-UCLA-MD1 (800) 825-2631
• (310) 825-7922 Gonda Diabetes Center in Westwood office
• (310) 828-1050 Gonda Diabetes Center in Santa Monica 
• (310) 205-7310 Beverly Hills Office 
• (818) 843-9020 Burbank Office 
• (818) 461-8148 Encino Office 
• (818) 271-2400 Porter Ranch office 
• (661) 753-5464 Santa Clarita Office 
• (805) 583-7640 Simi Valley Office 
• (805) 418-3500 Thousand Oaks office 
• (310) 542-6333 Torrance office 
• (805) 644-9121 Ventura Office 
• (805) 494-6920 Westlake Village office

• (310) 794-1299 Diabetes Education Services information

View a list of our endocrinology specialty locations >

By Fax

The following services offer referral forms that can be filled out online and faxed to the appropriate service.

1. The form serves as fax cover sheet and physician order.
2. Once the information is completed just fax the form, with records and insurance information, to the number is listed at the bottom of the form.
3. Please feel free to download the form as you can type directly onto the pdf or make copies for your files. 

Meet Our Expert Team

Our team is here to help. View a list of our clinicians >