End Stage Renal Disease (ESRD)

Diagnosis
End stage renal disease (ESRD)
Department
Nephrology and Hypertension; Pediatric Nephrology; Urology

1. Start the referral process:

Use your own referral form or notes* or download one of our forms:

2. Gather records:

For adult referrals, Nephrology and Hypertension:

  • Chem panel
  • Urinalysis
  • Last 3 visit notes
  • Any abdominal imaging

For Pediatric Nephrology:

  • Chart notes
  • Labs
  • Ultrasound report

For adult referrals, Urology:

  • Records from all providers previously treating Dx

3. Fax the referral and all records to 503-346-6854.

* Referral notes or forms should include:

  • Patient name, date of birth, sex, address and phone number
  • Referring provider’s name, address and phone number
  • Diagnosis or reason for referral
  • Department patient is being referred to
  • Most recent chart notes supporting the diagnosis or reason for referral

For help or to arrange provider-to-provider advice, call 503-494-4567.

Date Revised May 01, 2024