Amyotrophic Lateral Sclerosis (ALS)

Diagnosis
Amyotrophic lateral sclerosis (ALS)
Department
Neurology; Pulmonary Medicine

1. Start the referral process:

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

Adult referral form

2. Gather records:

For Neurology (Neuromuscular):

  • Previous neurology notes
  • EMG

For Pulmonary Medicine:

  • Chart notes supporting the diagnosis
  • Bronchoscopy study (if available)
  • Chest imaging - Chest X-ray (CXR) & Chest CT (if available)
  • Echocardiogram (if available)
  • Labs supporting the diagnosis
  • Arterial blood gas (ABG) (last year) (if available)
  • Lung biopsy report (if available)
  • All pulmonary function test reports (if available)
  • Pulmonary rehab reports (if available)
  • Sleep study, sleep clinic notes, nocturnal oximetry (if available)
  • Sputum study (sputum and bronchoalveolar lavage results including respiratory cultures and serologies) - lab studies (if available)
  • Thoracic surgery report (if available)
  • Allergist records & testing as noted above if the patient saw one for asthma or other pulmonary diseases.
  • Lung ventilation and perfusion scan (V/Q scan) - radiologic study (if available)
  • Right heart catheterization procedure report (if available)
  • Lung pathology reports (if available)
  • Neurology chart notes and studies
  • DME records (CPAP/BiPAP/ventilator/etc)

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 February 18, 2021