Dystonia

Diagnosis
Dystonia
Department
Comprehensive Pain Center; Neurology; Pediatric Neurology

1. Start the referral process:

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

2. Gather records:

For adult referrals, Comprehensive Pain Center:

  • Detailed reason for referral & what is being requested to evaluate
  • Last 3 months of chart notes
  • CT/MRI/PT/xray or ultrasound imaging results 

For adult referrals,  Neurology:

  • Recent chart notes
  • Push all Brain, Neck and Spine imaging to OHSU PACS and include report 
  • Genetic testing if available

For Pediatric Neurology:

  • No records required

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 June 02, 2021