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Important Forms
For Dr. McCloskey Patients Only:
For Prostate Cancer Patients Only:
A complete set of medical information will facilitate your care and save you considerable amounts of time. Please complete all above forms and fax them back to UCLA Radiation Oncology in Westwood at (310) 794-9795 or Santa Monica at (424) 259-8796 no later than 24 hours prior to your visit.
Patient Education Video >
What to do in preparation for your consultation
In order to make your consultation with your physician as informative and thorough as possible, the following information will be required:
- Health insurance identification cards
- If you belong to an HMO, please bring the authorization form if available, or the confirmation number.
- Please come at least half an hour before your scheduled appointment to fill out a medical self-reporting history and physical form, a Health Questionnaire Form, Patient Assessment Form, or a Referring Physician Form.
- It is very important that any medical records that are not at UCLA (imaging films/CDs (MRI/PET CT), operative reports and pathology slides/reports,) be available for your physician consult. Please make arrangements to bring these in for your consultation, or have them mailed/faxed ahead of time (ATTN: Scheduling Staff).
- Bring a list of all your medications and list any allergies to medications that you may have.
- If you have a pace-maker, please bring in your pace-maker identification card.
- If you speak a foreign language, and need a translator, please let us know at least 24 hours in advance, so that we can request an interpreter.
- Prepare a list of questions that you wish to ask the doctor. If you do this in advance, you will be less likely to forget something.
Below is a list of questions our patients typically ask:
- What is the purpose of radiation treatment for my type of cancer?
- How will the radiation therapy be given?
- What do the treatments feel like?
- For how many weeks/number of treatments will I receive radiation?
- What are the chances the radiation therapy will work?
- What are the side-effects for my type of cancer treatment?
- How are the side-effects handled?
- Will I be able to continue my normal daily living activities?
- Will I need weekly blood tests?
- What do I do about skin reactions?
- Can I participate in a clinical trial? If so, what is the trial testing? What are the benefits and risks?
- Will I need a special diet for radiation?
- What is the chance that the cancer will come back, if I don't have radiation therapy?
- Can I still work?
- Will radiation therapy affect my ability to have children?
- Will my insurance cover this treatment?
- If I have questions after today, who can I call to respond?
What to expect at the end of your consultation
- You will receive a general packet of information regarding radiation.
- You will see a video introducing you to the radiation process. Watch the patient education video
- After your consultation, our front desk with schedule your next appointment and/or referrals.
View map and directions to our office
Additional Information for Brachytherapy Patients
Surgical Procedures
Some of our Brachytherapy procedures can be performed in the department, while others require an outpatient procedure in the surgery center. In a few cases, an inpatient stay and procedure at Ronald Regan UCLA Medical Center is necessary. Please review the links below regarding our surgical centers at UCLA.
Pre-Op/Patient Instructions
