To determine the appropriate course of treatment for you, we would like you to complete a Patient Intake Form. To receive a copy of this form, please send an email to Vasken Mouradian, International Patient Coordinator with your name and fax number included.

Vasken.Mouradian@tenethealth.com

Please fax the completed form with any applicable films and test results to 323.442.8820. Once your information has been received a USC physician will review your medical history to determine appropriate treatment options. We should be able to send you a response within 72 hours. Treatment options and any medical services which must be provided will be reviewed with you.