Referring Physicians

Please use the referral form below when referring patients to Nephrology Associates of Lake County, LLC. Please contact the office directly for all emergency referrals.

• Please return the completed form below with the medical records. Also include a copy of the patient’s insurance card(s) front and back by fax to 352-383-4401.
  

• Referrals are reviewed and the patients are scheduled according to their acuity.
  Please don't hesitate to contact us at 352-383-1245 with any questions.

New Patient Referral Form

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