Required Information

Please fax the following information to 916-734-6034.

  • PT Records/Pathology
  • CD of CT, MRI, and/or PET Scans (required for appointment)
  • PT Demographic Information
  • PT Insurance Information (Subscriber Info, ID #, Customer Service Plan)
  • Authorization for CPT Code 99245, PT will not be scheduled without authorization
  • Referring MD Information
  • Referral Coordinator Contact Information with Direct/Back Line Phone Number

In addition, please mail Pathology Slides to Alicia Martinez at UC Davis Medical Center

4860 Y Street, Suite 2500
Sacramento, CA 95817

 

Contact Information:

UC Davis Comprehensive Cancer Center
Gynecologic Oncology
New Patient Referrals
2279 45th Street
Sacramento, CA 95817

Phone: (916) 736-6958
Fax: (916) 703-5266