Refer a Patient

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Refer a Patient

Refer a Patient  

Referral Instructions

For new referrals, be sure that your referral request includes the following items:

  • Physician Name, Office Address and Phone Number
  • Patient Name, Date of Birth and Parent or Guardian's Name
  • Reason for Referral
  • Clinic Name (see below for full list) or Physician Name for your referral
  • Insurance Information for Patient
  • Authorization (when required)

Most physician offices have a standard referral form in use. If your office would prefer to use our Children's Referral Form, please download and complete it and fax or scan it back to us. We look forward to assisting your patients in obtaining the care that they need.

Clinic Referral List

ADOLESCENT MEDICINE

Fax:  323-953-8116
Phone:  323-361-2153

ALLERGY & IMMUNOLOGY

Fax:   323-361-1191
Phone:3   23-361-2501

AUTISM SPECTRUM DISORDER ASSESSMENT

Fax:  323-361-8196
Phone:  323-361-6102

BONE MARROW TRANSPLANT

Fax:  323-361-8068
Phone:  323-361-2546

CARDIOLOGY

Fax:  323-361-1513
Phone:  323-361-2461

CARDIOTHORACIC SURGERY

Fax:  323-361-3668
Phone:  323-361-4148

CARDIOTHORACIC TRANSPLANT PROGRAM

Fax:  323-361-7979
Phone: 323-361-5965

CRANIOFACIAL

Fax:  323-361-3632
Phone:  323-361-2154

DENTISTRY

Fax:  323-361-1090
Phone: 323-361-2130

DERMATOLOGY

Fax:  323-953-8116
Phone: 323-361-4191

DEVELOPMENTAL-BEHAVIORAL PEDIATRICS

Fax:  323-361-8196
Phone: 323-361-6102

DEVELOPMENTAL DISORDERS

Phone: 323-361-2300

DIABETES

Fax:  323-361-8065
Phone: 323-361-4606

DIALYSIS

Fax: 323-361-4539
Phone: 323-361-2560

ENDOCRINOLOGY

Fax:  323-361-8065
Phone:  323-361-4606

GASTROENTEROLOGY

Fax:  323-361-3718
Phone: 323-361-2181

GENERAL PEDIATRICS (ALTAMED)

Fax: 323-361-7926
Phone: 323-669-2534

HEARING AND SPEECH

Fax: 323-361-1835
Phone:  323-361-4028

HEMATOLOGY AND ONCOLOGY

Fax:  323-361-3642
Phone: 323-361-4100

IMAGING SERVICES

Fax:  323-361-5169
Phone: 323-361-2411

Imaging Evaluation Form

INFECTIOUS DISEASES

Fax: 323-361-1183
Phone:  323-361-2509

KIDNEY TRANSPLANT PROGRAM

Fax:  323-361-1184
Phone:  323-361-2102

LIVER & INTESTINAL TRANSPLANT PROGRAM

Fax:  323-361-3612
Phone:  323-361-5454

MATERNAL & FETAL HEALTH

Fax:  323-361-6069
Phone:  323-361-7042

MEDICAL GENETICS

Fax:  323-361-1172
Phone:  323-361-2178

MENTAL HEALTH  

Fax:  323-361-3843
Phone:  323-361-2350

MITOCHONDRIAL DISORDERS CLINIC

Fax:  323-361-1172
Phone:  323-361-2178

NEONATOLOGY

Fax:  323-361-4016
Phone:  323-361-2531

NEPHROLOGY

Fax:  323-361-1184
Phone:  323-361-2102

NEUROLOGY

Fax:  323-361-1109
Phone:  323-361-2471

NEUROSURGERY

Fax:  323-361-3101
Phone:  323-361-2169

OPHTHALMOLOGY

Fax:  323-361-1592
Phone:  323-361-2347

ORTHOPAEDIC SURGERY

Fax:  323-361-3112
Phone:  323-361-2142

OTOLARYNGOLOGY - HEAD AND NECK SURGERY

Fax: 323-361-3717
Phone: 323-361-2145

OUTPATIENT REGISTRATION

Fax:  323-361-6050
Phone:  (800) 877-2452

PAIN MANAGEMENT CLINIC

Fax:  323-361-1001
Phone: 323-361-7686

PATHOLOGY AND LABORATORY MEDICINE

Fax:  323-361-8004
Phone:  323-361-2469

PEDIATRIC SURGERY

Fax:  323-361-4775
Phone:  323-361-2322

PHYSICAL AND OCCUPATIONAL THERAPY

Fax:  323-361-8166
Phone:  323-361-2118

PLASTIC SURGERY

Fax:  323-361-3632
Phone:  323-361-2154

PSYCHIATRY

Fax:  323-361-2019
Phone:  323-361-3430

PULMONARY CLINIC

Fax:  323-361-4533
Phone:  323-361-2287

PULMONARY FUNCTION LAB

Fax:  323-361-1364
Phone:  323-361-2162

RADIATION ONCOLOGY

Fax:  323-361-7977
Phone:  323-361-2417

RADIOLOGY

Fax:  323-361-5169
Phone:  323-361-2411

Radiology Evaluation Form

REHABILITATION

Fax:  323-361-8166
Phone: 323-361-2231

RHEUMATOLOGY

Fax:  323-361-1130
Phone:  323-361-2119

SCOLIOSIS

Fax:  323-361-3116
Phone:  323-361-2142

SLEEP CENTER

Fax:  323-361-1364
Phone:  323-361-2287

SPINA BIFIDA

Fax:  323-361-8566
Phone:  323-361-2384

TEENAGE HEALTH CENTER

Fax:  323-361-8116
Phone:  323-361-2153  

UROLOGY

Fax:   323-361-8034
Phone:   323-361-2247

VASCULAR ANOMALIES CENTER

Fax:   323-361-3632
Phone:   323-361-2154

REFER A PATIENT TO AN OUTPATIENT CLINIC

REFERRAL SERVICE
Monday - Friday, 8 a.m. - 5 p.m.

888-631-2452

ADMIT A PATIENT | REQUEST A TRANSPORT

24-HOUR LINE

888-631-2452

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