Vesicoureteral Reflux (VUR)

Diagnosis Vesicoureteral reflux (VUR); vesicoureteral reflux (VUR), unspecified or without reflux nephropathy
Department Urology; Pediatric Urology

1. Start the referral process:

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

2. Gather records:

For adult referrals, Urology:

  • Vesicoureteral reflux (VUR):
    • Records from all providers previously treating Dx
    • Imaging reports
    • Images pushed

       
  • Vesicoureteral reflux, unspecified or without reflux nephropathy:
    • Records from all providers previously treating Dx
    • Imaging reports
    • Images pushed

For Pediatric Urology:

  • Vesicoureteral reflux (VUR):
    • Obtain all previous urologic images, reports
    • PCP notes and UA cultures
    • Renal/Bladder Ultrasound at DCH
    • UA
    • Voiding forms, if potty trained.

       
  • Vesicoureteral reflux, unspecified or without reflux nephropathy:
    • Chart notes
    • Urine cultures
    • Images and image reports

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 01, 2024