Alzheimer’s Disease

Alzheimer’s disease

1. Start the referral process:

Use your own referral form or notes* or download our form:

Adult referral form

2. Gather records:

  • Neurology chart notes
  • Results from MoCA, SLUMS, or MMSE done within last 6 months
  • Push all Brain, Spine, Neck imaging to OHSU PACS and include report 
  • LABS: B12, TSH, CBC, CSF, or CMP, if available
  • Neuropsych testing, if available

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 May 17, 2021