UCLA Fibroid Treatment Program
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Comprehensive Fibroid Treatment

To Refer Yourself or Your Patient

Your first visit will provide us with dedicated time to discuss your concerns, review your medical history and provide you with education on the treatment options available to you. It only takes 3 easy steps to refer yourself or your patient

To Refer Yourself

  1. Call us and speak to a fibroid treatment coordinator
    (310) 481-7550
  2. Fill out the forms requested by your treatment coordinator
  3. Fax forms to Attn: UCLA Fibroid Program (310) 794-9070
* Please fill out the questionnaires and bring them with to your initial consultation.

To Refer Your Patient

  1. Fill out the health and physical form for your patient
  2. Fill out a radiology requisition form
  3. Fax both forms to Attn: UCLA Fibroid Program (310) 794-9070

Forms

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