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Referring forms

Download Patient Referral Forms:

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ESRD Patient Referral Form

(in PDF format)

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Medication Reconciliation Form

(in PDF format)

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PI Vascular Lab Order form

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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. Suite E
North Hollywood, CA 91606
Tel:  888_526_4848

Fax: 818_927_2088
​Email: stevenorellana@lcmd247.com

Contact Us
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