Referral contact information and forms

Referral phone numbers and forms

Please refer to the list of phone and fax numbers for the appropriate specialties and departments. Note that some specialties require additional information to refer a patient. 

For your convenience, we have a general referral form available: 

• General referral form PDF

Chao Family Comprehensive Cancer Center

Referral Phone: 714-456-7001
Referral Fax: 855-211-3729

Ear, Nose and Throat

Referral Phone: 714-456-7001
Referral Fax: 855-854-5414
Note: Please call to obtain the CPT codes required for referrals.

Gastroenterology/Colorectal

Referral Phone: 888-717-4463
Referral Fax: 855-813-0240

Neurosurgery

Referral Phone: 714-456-7001
Referral Fax: 844-677-8698
Note: Recent note and images are required for referrals and will be reviewed before scheduling.

Ophthalmology

Referral Phone: 714-456-7001 
Referral Fax: 855-376-5057
Note: Please call to obtain the CPT codes required for referrals

Plastic Surgery Services

Referral Phone: 714-456-3077
Referral Fax: 714-456-2229

Radiology Services

Referral Phone: 714-456-5571
Referral Fax: 714-456-5627

Rehabilitation Services

Referral Phone: 888-717-4463
Referral Fax: 714-456-5346
Note: Please call to obtain the CPT codes required for referrals.

Urology

Referral Phone: 714-456-7001
Referral Fax: 877-829-7891

Women's Health and Maternal-Fetal Medicine

Referral Phone: 714-456-7001
Referral Fax: 877-853-4613 
Note: Recent note is required for referrals and will be reviewed before scheduling.

General/All other specialties

Referral Phone: 714-456-7001
Referral Fax: 855-209-8413