Stem Cell Clinic of California.

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Information & Forms

Referring Physicians

Colleagues, thank you for trusting us with the continuing care of your patient. We have developed two forms to help make the transmission of information and records seamless and allow us to step in and begin care immediately.

If you have any questions about our treatments or the referral process, please contact our office at (626) 345-9735 or email us using the form above. Please email the following information to:

  • Written order

  • Recent visit notes, medication history & imaging

  • Insurance & demographic information

  • Authorization
    (if required)

We require a written referral for all new patients.

Request An Appointment

Same-day appointments may often be available, so please call our office if you want an appointment today.

Please be aware that you are submitting a request only. A representative from our office will contact you within 24 to 48 business hours to confirm a date and time.

If this is a medical emergency, please do not fill out this form, call 911.

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