Referring forms

Download Patient Referral Forms:

ESRD Patient Referral Form

(in PDF format)

Medication Reconciliation Form

(in PDF format)

PI Vascular Lab Order form

Available Treatments
  • Dialysis Fistula & Graft Interventions

  • Interventions for Peripheral Arterial Disease (PAD)

  • Hemodialysis Catheter Interventions

  • Central Venous Access for Dialysis, Nutrition and Chemotherapy

  • Venous Procedures

  • Percutaneous Urologic Procedures

  • Uterine Fibroid Embolization

12134 Victory Blvd. 
North Hollywood, CA 91606
Tel:  888_526_4848

Fax: 818_927_2088
Mail: Clinica1@nhcvc.com

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