Abnormal Results on Imaging Study of Genitourinary System

Diagnosis
Abnormal results on imaging study of genitourinary system
Department
Urology; Pediatric 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, Urology:

  • Records from all providers previously treating Dx

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 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
Date Revised June 15, 2021

Refer a patient

  • Fax your referral to 503-346-6854.
  • For help or to arrange provider-to-provider advice, call 503-494-4567 , option 4.