For Physicians

Referring Physician Resources & Forms

UMIH provides comprehensive services to your patients. We have provided you with the online tools to better process your patients. Our staff will be happy to help you with any questions if you would like to contact us directly at (310) 474-9800 ext. 106.

 

Form Downloads by Location

Referral forms are regionalized and can be accessed below. All forms are in Adobe PDF format. If you do not currently have Adobe Read installed, you can download it at the link below.

  • LOS ANGELES - WEST

    Beverly Hills, Century City, Downtown Los Angeles

    PDF download form
  • LOS ANGELES - SOUTH

    Gardena, Torrance, Inglewood

    PDF download form
  • LOS ANGELES - EAST

    Downey, East Los Angeles, Maywood

    PDF download form
  • ORANGE COUNTY

    Buena Park, Brea, Garden Grove, Huntington Beach, Irvine, Fountain Valley, Anaheim

    PDF download form