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North Office: The Arbors at Creek’s Edge 4100 Duval Rd., Bldg. IV, Ste. 102 Austin, TX 78759

Judith A. Betts, MD Cristian Cipleu, MD Amsalu Erko, MD Peter B. Hines, MD Timothy R. Hines, MD Ting-Chi Lu, MD Krzysztof Lyson, MD Helen J. Maidment, MD. Neil Manek, MD Ravi Mididoddi, MD Peter L. Miller, MD Scott Moore, MD Paul C. Nader, MD Yasser Nasser, MD Annalisa Perez, MD

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North Office: The Arbors at Creek’s Edge 4100 Duval Rd., Bldg. IV, Ste. 102 Austin, TX 78759

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  1. Judith A. Betts, MD Cristian Cipleu, MD Amsalu Erko, MD Peter B. Hines, MD Timothy R. Hines, MD Ting-Chi Lu, MD Krzysztof Lyson, MD Helen J. Maidment, MD Neil Manek, MD Ravi Mididoddi, MD Peter L. Miller, MD Scott Moore, MD Paul C. Nader, MD Yasser Nasser, MD Annalisa Perez, MD William Rodriguez, MD Mark S. Rosen, MD Nicholas Rowder, MD Edith Simmons, MD Karon S. Simpson, MD Sujatha Venkatesh, MD Malavika Vinta, MD Byron R. Welch, MD Dedicated to providing compassionate and comprehensive care. www.austinkidney.com Patient Referral Pad • Please fax the following to: • (512) 459-1399 • Labs: All Basic Metabolic Panels, CMP and 24 hour Urine Studies • * If labs are more than 2 months old, please send patient to get the following tests: • Renal panel, CBC, UA • Imaging:Abdominal or Renal: • Ultrasounds • CT Scans • MRI’s • Please also send the patient’s: • Medication List • Problem List • Physician Notes: Last 2 visits • Patient’s demographic sheet • Copy of patient’s insurance cards • If an insurance referral is required, please send with the patient’s records. Patient Name: DOB: Phone: Referring Physician: Physician Phone: Reason for referral: • Elevated Creatinine • High Potassium Levels • Hematuria • Abnormal Renal Ultrasound • Kidney Failure • Other Office Locations: North Locations: South Locations: North Office: The Arbors at Creek’s Edge 4100 Duval Rd., Bldg. IV, Ste. 102 Austin, TX 78759 For an appointment, please call 512-320-1500 or 1-888-320-9131 South Office: 321 W Ben White Blvd, Ste. 205 Austin, TX 78704 Kyle Office: 134 Elmhurst Drive Kyle, TX 78640 Bastrop Office: 441 Hwy 71, Ste. H Bastrop, TX 78602 Cedar Park Office: 1720 E Whitestone Blvd, Ste. ACedar Park, TX 78613 Central Locations: West Central Office:408 W 45th Street Austin, TX 78751 East Central Office: 3000 N IH-35, Ste. 635 Austin, TX 78705 Round Rock Office: (Behind Round Rock Medical Center)16010 Park Valley Dr., Ste. 100Round Rock, TX 78681 Georgetown Office:Austin Avenue Medical Plaza 3201 South Austin Ave, Ste. 325 Georgetown, TX 78626

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