1. Start the referral process:

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

• Adult referral form
• Pediatric referral form

2. Gather records:

For adult referrals, Nephrology and Hypertension:

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

For Pediatric Nephrology:

• No records required

For adult referrals, Urology:

• Records from all providers previously treating Dx
• Imaging reports
• Images pushed

For Pediatric Urology:

• Chart notes
• Images and image reports

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 providers 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