Referral Form

Referring Doctors

You may refer your patient to our office by filling out our Referral Form. After you have completed the form, please make sure to give it to your patient to bring with them to their appointment or, you may fax it to our office.

Technical Note:

Our forms use the Adobe Acrobat viewer to allow doctors the convenience of completing their referral form from home or work. Please download the free plugin from Adobe's web site if it is not already installed on your system.

485 34th St. #200
Oakland CA 94609
Telephone: 510-547-7668
Fax: 510-547-7665
Email: oakland@rezaidds.com

2411 Webb Ave. St. A
Alameda CA 94501
Telephone: 510-521-7668
Fax: 510-521-7662
Email: alameda@rezaidds.com

10 Orinda Way
Orinda CA 94563
Telephone: 925-254-7669
Fax: 925-254-7661
Email: orinda@rezaidds.com