For a successful referral, please have your referring provider (typically your primary care doctor-PCP) fax the below information/documents to the office you wish to be seen at (numbers below):
- Most recent office visit note from referring provider (typically PCP)
- Most recent lab work- Urine and Blood (can be a part of office visit note above)
- Preferred- lab work (urine and blood) from past calendar year
- Current Medication List
- Any imaging reports of the kidney
- Demographic Sheet- *Including all insurance information and copy of cards if possible*
- Referral note from Physician
If you are covered by an HMO, please include an authorization from your insurance company.
FAX 772-978-5815