NEPHROLOGY REFERRAL FORM‍ ‍ ‍

Thank you for your referral. We value your trust and appreciate the opportunity to care for your patient. Our goal is to provide timely, personalized nephrology care with clear communication throughout the referral process.

Our Commitment to Referring Physicians

When you refer a patient to Dr. Gedala Nephrology, you can expect:

✓ Timely appointment scheduling
✓ Thorough nephrology evaluation
✓ Clear assessment and management recommendations
✓ Prompt communication following consultation
✓ Collaboration with your ongoing care plan

We strive to provide specialized kidney expertise while maintaining open communication and continuity with your office.

Referral Instructions

Please fax the referral and supporting documents to: 210-866-1956

Referring Provider Information

☐ Referring provider information
☐ Reason for referral
☐ Recent office note
☐ Current medication list

Patient

☐ Patient demographics (including contact information)
☐ Insurance information (if available)

Medical Records

☐ Recent laboratory results
☐ Relevant imaging (if applicable)
☐ Pertinent medical records

Once we receive your referral, our team will promptly review the information, contact the patient directly, and strive to schedule a new patient appointment within 3–5 business days.

Questions?

Phone: 210- 876-3658

Fax: 210-866-1956

Address: 7434 Louis Pasteur Dr, Suite 102, 78229, San Antonio, Texas

Thank you for your trust and referrals. We appreciate the opportunity to care for your patients and value our partnership in providing exceptional kidney care.