Refer a Patient

Are you a physician interested in referring a patient to Dr. Duma? We make the process simple and quick. Please enter below the information about the patient you would like to refer to Dr. Duma. Additionally, provide some basic contact information about what physician and/or facility is referring the patient. Once this form is submitted, we will review and contact the patient within 2 business days to schedule a consultation.

Dr. Duma is a leading Brian Surgeon specializing in brain tumor surgery, restorative neurology and surgery for Parkinson’s disease and other movement disorders. Located in Newport Beach, California Dr. Duma is recognized as a thought leader in the industry of Nuerology, and is one of the most qualified and experienced Brain Surgeons in California.

Have a question you’d like to ask Dr. Duma? Feel free to email him directly with your patient related question(s) at drduma@cduma.com.

Patient Information

First Name: *
Last Name: *

Address: *

City: *
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Email: *
Phone Number: *

Date of birth:

Gender:

Patient is Interested In

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Refering Doctor's Information

First Name: *
Last Name: *

Address: *

City: *
State: * Zip Code:

Email: *
Phone Number: *

Fax Number: *