Nonalcoholic Liver Disease (Other Chronic Nonalcoholic Liver Disease)

Diagnosis
Nonalcoholic liver disease (other chronic nonalcoholic liver disease)
Department
Abdominal Organ Transplant

1. Start the referral process:

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

2. Gather records:

  • Recent chart notes (6 months back)
  • Lab: Complete Metabolic Panel, CBC, and INR (Drawn within last 2 months)
  • Current Medications List
  • Any Abdominal CTs and MRIs from the last 6 months. Fax reports and push images into OHSU PACS system or burn to disk. Dicom-Uncompressed formats only.
  • Last EGD and colonoscopy with pathology reports, if done.
  • Screenings:
    • HIV Screen (within last 6 months)
    • Serum Alcohol
    • Urine Drug Screen with confirmation (opiates, cocaine, marijuana, barbiturates, and amphetamines)
    • Alcohol Screening PEth Blood alcohol testing (preferred) or Urine Ethyl Glucuronide 
    • Urine Nicotine with metabolites

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

For help or to arrange provider-to-provider advice, call 503-494-4567.

Date Revised May 23, 2023