New Patient Appointments and Referral

Patient Appointment Forms and Information

Please complete the Patient Self-Referral form to initiate the new patient appointment process. A member of the UCLA Kidney Cancre Program TEAM will contact you to gather additional information prior to confirming your appointment.

 

Physicians Referring Patients -Forms and Information

Please complete and send the Physician Referral  form to initiate the new patient referral process. A member of the UCLA Kidney Cancer Program Team will first contact a representative in your office to collect additional patient information. Once we receive the necessary patient information the patient will be contacted and the appointment confirmed.

Referrals may also be made by phone or
fax as follows.

Hours:  8:00 a.m. to 5:00 pm PST, Monday-Friday
Phone: 310-794-7700
Fax:  310-794-7787
(Attention: UCLA Kidney Cancer Program)
E-mail: KCP@mednet.ucla.edu

All e-mail Referral Forms received prior to 1:00 pm PST will receive a response, either by phone or e-mail, by 5:00 pm the same business day. Messages received after 1:00 p.m. will be answered by noon the next day of business. (Mon - Fri)

Patient Information Needed Prior to Appointment

Certain administrative requirements must be completed before you meet with your physician. A UCLA Kidney Cancer Program Patient Coordinator will contact you to confirm and complete any open items on your Referral Form. In addition, University regulations require that you review the personal and financial information given at the time you scheduled the appointment. Also, you will be asked to sign two documents:

1. "Terms and Conditions of Service and Privacy Notice," which authorizes the physician to see and examine the patient and legally describes other terms and conditions of treatment.
   
2. "Consent to Blood Transfusion," which is required by law in California (the "Gann Act") and describes options available to patients who need or may need transfusion of blood or blood products.

Receiving a completed copy of the KCP Patient Health Questionnaire prior to your initial visit would help our Kidney Cancer Team Members to become more familiar with your medical history. Upon completion, please FAX the completed form to the UCLA Kidney Cancer Program at 310-794-7787. If you are unable to fax or mail the form, please bring the completed form with you on your first visit.

You will also be asked for evidence of your healthcare coverage (a copy of your health insurance identification card) and, if you are covered by any form of managed care plan (Health Maintenance Organization or Preferred Provider Organization), for a copy of your authorization to be seen at UCLA.

These documents are important, and not having either with you at the time of your appointment will require that the appointment be rescheduled.

Copies of the "Terms and Conditions of Service" and of the "Consent to Blood Transfusion" should be reviewed carefully prior to your appointment. We also ask that you please arrive 30 minutes before the scheduled appointment time so that administrative matters do not delay your meeting with your physician.

In addition, the KCP Patient Coordinator may also request specific medical and/or pathology reports prior to your appointment for the doctors to review prior to your first visit.

The UCLA Kidney Cancer Prgram Patient Coordinator will make every effort to work with you, or your referring physician, to make an appointment as quickly as possible. In most cases, our patients are first seen in our outpatient clinic, rather than being admitted to the hospital. 

 

Information About Your Initial Consultation

This page contains information about the what you will need to bring with your on your first visit to the UCLA Kidney Cancer Program Clinic, as well as other information that we hope will make your visit here easier.

A review of your medical history is an important part of the initial consultation. So that the physicians who will be seeing you during your visit can have the benefit of your complete medical history, please bring with you:

• If you have not already faxed or mailed a completed copy of the KCP Patient Health Questionnaire to the UCLA Kidney Cancer Program office prior to your initial visit, please bring a completed form with you to your initial visit.
  
• Copies of your pertinent medical records from the referring physician
  
• Copies of any Radiology Films or Tests (X-rays, CT Scans, MRI’s, Other)
  
• Any Pathology Reports (With Blocs or Slides if possible)
  
• If you need any of these materials returned to you at the conclusion of your appointment, please tell the physician who examines you.
  
  

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