How to Refer a Patient

By Phone

UCLA Physician Referral Service - 1-800-UCLA-MD1 (800-825-2631)
Burbank - (818) 843-9020
Encino - (818) 461-8148
Porter Ranch - (818) 271-2400
Redondo Beach - (310) 937-8555
Santa Clarita - (661) 255-2420
Santa Monica - (310) 582-6240
Thousand Oaks - (805) 418-3500
Westlake Village - (805) 494-6920
Westwood - (310) 825-1597

Medical Procedures Unit - General Inquiries - (310) 825-6676

Our Locations
We have locations in Burbank, Encino, Porter Ranch, Redondo Beach, Santa Clarita, Santa Monica, Thousand Oaks, Westlake Village and Westwood to serve you >

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.