OHSU's criteria for Long COVID referrals is 28 days from hospital discharge, or 3 months when not hospitalized. Referrals for the Long COVID program must come from the patient's Primary Care Provider.

We offer a program for adults and a Long COVID provider will help you manage this condition, which may include referrals to specialists if needed. For Long COVID pediatric diagnoses, please refer patients directly to an OHSU pediatric specialist as needed.

1. Start the referral process:

For Long COVID diagnoses, use your own referral form or download our form and include chart notes listed in number 2, indicate “Long COVID Clinic” in the “Other” specialty section of the form:

Adult patient referral form 

For Long COVID pediatric diagnoses, please refer patients directly to an OHSU pediatric specialist as needed. Due to capacity constraints, we are temporarily unable to accept new patient referrals to the Long COVID Pediatric Clinic at this time. To refer a patient to Doernbecher Children's Hospital, use your own referral form or notes* or download our form:

Pediatric referral form

2. Gather records:

For adult referrals, COVID Connected Care Center:

  • Chart notes, labs, and diagnostic imaging over past 6 months
  • Discussion of specific Long COVID symptoms

For pediatric referrals, please review the patient referral checklist by specialty, and refer patient directly to the OHSU pediatric specialist to address the specific symptoms.

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 (for adult long COVID diagnoses, please indicate "other" on the adult referral form and enter "Long COVID Clinic" in the space provided.)
  • Most recent chart notes supporting the diagnosis or reason for referral

Questions? Call 503-494-4567  weekdays 8 a.m. to 5 p.m. 

Date Revised January 11, 2023