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Refer a Patient

Patients are considered for evaluation by physician referral or self referral.

University Transplant Center is a comprehensive program that offers specialty services tailored to patients’ individual needs. In order for us to provide an initial evaluation, please follow the steps provided under each program. Any incomplete or missing information will result in the referral being delayed.

Direct Fax: (210) 358-0408
Services include pediatric and adult kidney transplantation, pancreas transplantation, and living kidney donor transplantation evaluations.

Step 1: Submit the online referral form or print one of the following to include with Step 2:

Step 2: Fax or mail the following information:

  • Patient’s demographic form
  • Copy of insurance cards (front and back)
  • Recent history and physical
  • Most recent labs
  • Immunizations
  • Medication List
  • Recent chest x-ray
  • Form 2728
  • Any cardiology testing
  • Last two office visits or dialysis run sheets
  • C-Peptide (pancreas referral)

Step 3: A coordinator will review your referral and contact you within 48 business hours.

Direct Fax: (210) 702-4146
Services include pediatric and adult liver transplantation, liver and pancreatic cancer surgery, and advanced liver disease management evaluations.

Step 1: Submit the online referral form or print one of the following to include with Step 2:

Step 2: Fax or mail the following information:

  • Patient’s demographic form
  • Copy of insurance cards (front and back)
  • Recent history and physical
  • Most recent labs
  • Immunizations
  • MRI/CT/SONO/MRCP/ERCP of abdomen/liver
  • Pathology reports
  • Last two office visits

Step 3: A coordinator will review your referral and contact you within 48 business hours.

Direct Fax: (210) 358-8254
Services include adult lung transplantation, pulmonary hypertension, bronchoscopies, and interventional pulmonology evaluations.
Step 1: Submit the online referral form or print the following to include with Step 2:

Step 2: Fax or mail the following information:

  • Patient’s demographic form
  • Copy of insurance cards (front and back)
  • Recent history and physical
  • Most recent labs
  • Immunizations
  • Last three PFT reports
  • Recent CXR reports
  • All Chest CT reports
  • Sputum cultures and sensitivities (if available)
  • Any cardiology testing
  • Lung biopsy pathology report (if available)
  • Hospital discharge summaries (if applicable)

Step 3: A coordinator will review your referral and contact you within 48 business hours.

If mail option is preferred, please send all necessary documentation to:

University Transplant Center
4502 Medical Dr. MS 18
San Antonio, TX 78229

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