Refer a Patient: Polycystic Kidney Disease (PKD) Center of Excellence
Please gather the following materials and fax them to us:
- A completed UCSF referral form
- Patient's demographic information
- Photo of patient's insurance card (front and back)
- Serum creatinine values (such as BUN, creatinine, eGFR, CO2, serum potassium, serum sodium, and glucose) from within the past three months
- Previous nephrologist's notes, if patient has seen one
- Renal imaging on a CD and results (MRI, CT or ultrasound)
Please check if the patient's insurance requires an authorization/RAF/PCP referral and fax the appropriate documents to our new patient fax line at (415) 353-2530. Use CPT code 99205 if authorization is needed. If no authorization/RAF/PCP referral form is required, please indicate this.
If you need assistance, give us a call.
We're currently enrolling patients for two clinical trials on ADPKD, listed below. To have a patient evaluated for eligibility, use the new patient referral process outlined above.
Inpatient: (415) 353-1323