Whether you or a member of your family needs a to see gastroenterologist or a surgeon for your esophageal issues, our team will help you find not only a great doctor, but one who practices in the medical center that has been ranked year after year among the top five in the United States and the No. 1 in the West by U.S. News and World Report.
UCLA Physician Referral Service
UCLA Esophageal Disorders Program
Head and Neck Surgery
Santa Monica UCLA Gastrointestinal Oncology
Make an Appointment by Email
Request an Appointment
Refer a Patient by Fax
The following services offer referral forms that can be filled out online and faxed to the appropriate service.
- The form serves as fax cover sheet and physician order.
- 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.
- Please feel free to download the form as you can type directly onto the pdf or make copies for your files.
Medical Procedure Unit Phone - (310) 825-6676
Medical Procedure Unit Fax - (310) 794-4463
Clinic Phone - (310) 208-5400
Clinic Fax - (310) 208-3788
Interventional Endoscopy Services
Phone - (310) 267-3636
Fax - (310) 267-0007
We have locations in Burbank, Encino, Porter Ranch, Redondo Beach, Santa Clarita, Santa Monica, Thousand Oaks, Westlake Village and Westwood to serve you >