Referral Guidelines

Developed by CHOC Specialists, in partnership with community physicians, these guidelines provide you with useful information in working up your patients, and contribute to making the appointment itself most meaningful by having the right clinical information available.

 

Listed below are the specialties that currently have guidelines. Updates, as well as additional specialties and diagnoses, are added regularly.

 

      Allergy & Immunology

  • Allergy & Immunology Referral Guidelines: Allergic Rhinitis, Anaphylaxis

     

    Cardiology

  • Cardiology Referral Guidelines: Heart Murmur, Palpitations, Arrhythmia, Abnormal ECG, Chest Pain, Syncope, Hypertension, Attention Deficit Disorder, Kawasaki Disease, Genetic Disorders: Marfan, Turner, Downs, DiGeorge, Noonan, Muscular Dystrophy, Premature, Patent Ductus Arteriosus (PDA), Atrial Septal Defect (ASD), Small Ventricular Septal Defect (VSD), Hyperlipidermia.

     

    Developmental & Behavioral Pediatrics

  • Developmental & Behavioral Pediatrics Referral Guidelines: Attention Deficit Disorder, Hyperactivity, Inattentiveness, Developmental Delay, Autism, Asperger, Pervasive Developmental Disorder, Tic Disorders, Tourette’s, Selective Mutism, Anxiety Problem, Oppositional Defiant Disorder, Learning Disorder

     

    Endocrinology

  • Endocrinology Referral Guidelines: Growth Disorders, Thyroid Disorders and Pubertal Disorders including, Congenital Hypothyroidism (Neonate), Congenital Hypotheyroidism (Child), Acquired Hypothyroidism, Autoimmune Thyroiditis/Hypothyroidism, Central Hypothyrodism, Acquired Hyperthyroidism, Auntoimmune Hyperthyroidism (Grave’s Disease), Neonatal Hyperthyroidism, Goiter, Thyroid Nodule, Diabetes Mellitus Type 1 & Type 2, Hyperglycemia, Impaired Glucose Tolerance, Impaired Fasting Glucose, Morbid Obesity, Acanthosis Nigricans, Short Stature, Failure to Thrive, Precocious Puberty/Premature Thelarche (Girls), Precocious Puberty (Boys), Premature Adrenarch (Girls), Premature Adrenarch (Boys), and Delayed Puberty.

     

  • Endocrinology Referral Request Form

    Gastroenterology

  • Gastroenterology Referral Guidelines: Chronic Abominal Pain, Celiac Disease, Crohn’s Disease, Diarrhea, Hematochezia, Food Allergy, Peptic Ulcer Disease, Gastro Esophageal Reflux (GER), Vomiting, Constipation, Failure to Thrive.

     

  • Gastroenterology Referral Request Form: Abdominal Pain, Diarrhea, Weight Loss, GI Bleed, GERD, Jaundice, Constipation, Growth Failure, Vomiting

     

    Hematology

  • Hematology Referral Guidelines: Anemia, Thrombocytopenia, Neutropenia, Coagulation Defect, Recurrent Infections

     

  • Hematology Referral Request Form: Anemia, Thrombocytopenia, Neutropenia, Bleeding Disorders, Thrombosis, Recurrent infections, Di George Syndrome, Hypogammaglobulinemia, Chronic Granulomatous Disease, Hemangioma, Vascular Malformations, Port Wine Stain but no Lymphangiomas

     

    Hospitalist

  • Hospitalist Preference Form

     

    Infectious Disease

  • Infectious Disease Referral Guidelines: Recurring Fevers, Recurrent Staphylococcal Infections, Latent Tuberculosis Infection

     

  • Infectious Disease Referral Request Form

     

    Nephrology

  • Nephrology Referral Guidelines: Microhematuria, Gross Hematuria, Proteinuria, Acidosis, Cystic Kidneys, Hypertension

     

  • Nephrology Referral Request Form

     

    Neurology

  • Neurology Referral Guidelines: Recurrent Unprovoked Seizures (Epilepsy), Febrile Seizures, First Unprovoked Seizure, Developmental Delay, Tics, Tourette’s, Autism, Pervasive Developmental Disorder, Concussion, Headaches

     

  • Neurology Referral Request Form: Non-Febrile Seizures, Intractable Epilepsy, Neuromuscular Disorders, Headaches with Neurological Findings

     

    Ophthalmology

  • Ophthalmology Referral Guidelines: Visual Behavior / Acuity, Eyelids, Nasolacrimal System, Anterior Segment, Ocular Media. Sensorimotor System (Pupils and Ocular movements), Prematurity, Systemic Disorders, Congenital Deformities & Syndromes, and Non Accidental Injury

     

    Pulmonology

  • Pulmonology Referral Guidelines: Infant Apnea, Child Apnea, Asthma, Brochopulmonary Dysplasia (BPD), Chronic Cough, Cystic Fibrosis, Recurrent Pheumonia, Respiratory Syncytial Virus (RSV)

     

    Rheumatology

  • Rheumatology Intake Form

     

  • Rheumatology Referral Guidelines: Arthralgias, Joint Swelling, Joint Contracture, Limp Joint, Weakness, Back Pain, Malar Rash, Proteinuria, Hematuria, Unexplained Fevers, Weight Loss, Skin Tightening, Extremity Color Changes, Iritis, Chronic Pain, Positive (+) ANA

     

  • Rheumatology Referral Request Form

Please note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.