Celebrating 33 years of service as Northern Nevada’s premier kidney health specialists.


Patient Name:

Date of Birth: (YYYY-MM-DD)

Your e-mail: (you@yourdomain.com)


Diagnosis/Reason for Consult:
Elevation of Creatinine Proteinuria
Hypertension Hematuria
Abnormal Imaging Study Family History of Renal Disease
Abnormal Laboratory Study History of Renal Transplant
Kidney Stones Urine Infections
Other:
Urgency:
Offices:
Reno / Sparks Carson City
Fallon Winnemucca
Elko Truckee

Please include the following documents with all new patient referral requests:
  1. Most recent physician evaluations (Hospital notes, Hospital H & P, etc.)
  2. Last 1 year of laboratory results
  3. Any pertinent imaging reports
  4. Patient demographic information

Please choose the files for uploading:






(.jpg,.bmp,.tif,.tiff,.pdf,.doc,.docx,.xls,.xlsx)


Contact Us:
(775) 322-4550 (Main Line)
(775) 322-4583 (Physician to Physician Line)

Click here to download a pdf to print, complete and fax.

Completed forms can be faxed to:

775.322.4776

Latest News

670 Sierra Rose Drive
Reno, NV 89511

Night Clinics now available for new patients, 5-8pm