Benign Localized Hyperplasia of Prostate with Urinary Obstruction and Other Lower Urinary Tract Symptoms

Benign localized hyperplasia of prostate with urinary obstruction and other lower urinary tract symptoms (LUTS)(600.21)

1. Start the referral process:

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

Adult referral form

2. Gather records:

  • 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 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
Date Revised February 20, 2021