Referring Physicians

For Referring Physicians

Dear Referring Physicians,

Our office is experiencing an overwhelming amount of referrals for Pediatric Neurology consultations. In order to process your request, we will need the following paperwork faxed to (909) 835‐1777.

  • A legible referral form signed by the referring physician. (Form is available on this website under the referral section).
  • All pertinent medical records including: clinical history, laboratory results, neurological imaging and EEG results.
  • Authorization for cpt codes 99241 – 99245 (if required by the patients’ insurance).

If you would like to make an emergent referral, that requires consultation within the week we advise that the physician call our office at (909) 835‐1810 and speak to one of our neurologists directly.

Our goal is to accommodate all requests in a timely manner. Thank you for your understanding and cooperation. We look forward to continuing to work together for the optimal health and happiness of our patients and their families.

Click here to print out the "Pediatric Neurology Referral Form" and fax to 909-835-1777.

Loma Linda University Health Care
Pediatric Neurology