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
    • LOS ANGELES - North

      Northridge, Santa Clarita

      PDF download form
    • West Covina

      West Covina

      PDF download form