Important Documents to Bring to Your Visit

We can serve you best, if you fill out a Health History form and mail or fax it to us prior to the visit for our review.

If this is not possible please bring it with you to your appointment. We suggest patients also bring a copy of their forms and records in addition to mailing or faxing a copy. Download/Print Health History form

Address
General Surgery Clinic
Attn: Colorectal Surgery Program
200 UCLA Medical Plaza Suite 214
Los Angeles, CA. 90095-7302

Fax
(310) 794-1039 (Attn: Colorectal Surgery Program)

A complete set of medical information will facilitate your care and save you considerable amounts of time.

1. Colonoscopy or flexible sigmoidoscopy report (with photos, if possible)
2. Pathology report and slides (if possible)
3. Radiographic images (CT scan, MRI, ultrasound, x-rays) – bring both report and hard copies
4. Any pertinent medical records (operative reports, doctor’s notes)
5. Anal physiology testing reports (manometry, ultrasound, defecography, PNTML, etc)