Pre-visit Checklist

CTD-ILD Program Pre-visit Checklist

Prior to your appointment, please fax the following medical records to our office at (310) 206-5088:

Required Records: These records must be sent prior to your appointment

• Pulmonary function tests (i.e. PFTs): Please fax all PFTs; at a minimum, please fax most recent PFT report.

• Chest CT scan (i.e. CAT scan of lungs): Please fax CT scan report. In addition, please obtain a CD with the CT images of lungs on it and bring it to your clinic appointment.

• Medication list: Please fax a list of your current medications. Please also fax a list of any medications you have taken in the past for your lung disease and autoimmune disease and the dates you took these medications.

• Doctor’s notes: If you have not been seen by a UCLA doctor, please fax any doctor’s notes to our office (i.e. your Rheumatologist or your Pulmonologist).

• Recent lab reports: Please fax any lab reports. If you have had labs tests that measure antibody levels, please fax these reports to us.

Optional Records: If you have already had the tests listed below done, please fax the reports to our office prior to your appointment.

• Transthoracic echocardiogram

• Lung biopsy reports

If you have any questions about the pre-visit check list, please call our clinical coordinator at (310) 825-5800.