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CHOC Docs :: Referral Guidelines and Forms
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Referral guidelines and forms are available to assist physicians in the evaluation and management of pediatric patients.

Developed by CHOC physicians, 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 and forms. Updates, as well as additional specialties and diagnoses, are added regularly.

Consult/Referral Guidelines and Referral Request Forms 

Allergy & Immunology Cardiology Endocrinology
  • CHOC Children's Specialists 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.
  • CHOC Children's Specialists Endocrinology Referral Request Form
    General Endocrinology Clinic, Growth Clinic, Diabetes Clinic
  • CHOC Children's Specialists Endocrinology Practice Profile
    Provides a one-sheet resource of commonly treated conditions, services offered, location and contact information for referrals. For more comprehensive information, please see the Referral Guidelines.
Gastroenterology Hematology Hospitalist Infectious Disease Nephrology Neurology Ophthalmology Othopaedics Otolaryngology Pediatric Surgery Pulmonology Radiology Rheumatology Urology
  • CHOC Children's Urology Referral Guidelines
    Balanitis, Bladder Stones, Circumcision (elective), Cloacal Anomaly, Congenital Adrenal Hyperplasia, Congenital Cystic Kidney, Duplicated Collection System, Dysfunctional Voider, Dysuria, Dysuria (psychogenic), Fistula (urethrocutaneous), Frequency, Hematuria (gross), Hematuria (microscopic), Hernia (inguinal), Hidden Penis, Hydrocele, Hydronephrosis, Hydronephrosis (congenital), Hypospadias (male), Incontinence (urine – non specific), Kidney Stones, Labial Adhesions, Meatal Stenosis, Megaureter, Megaureter (congenital), Micro Penis, Multi Cystic Dysplastic Kidney, Neonatal Circumcision, Neurogenic Bladder, Nocturnal Enuresis, Paraphimosis, Penile Adhesions, Penile Curvature, Phimosis, Posterior Urethral Valves, Pyelonephritis, Solitary Kidney, Spina Bifida (occulta), Testicular Pain, Testicular Pain (psychogenic), Torsion, Undescended Testis, Urachal Remnant, Ureteral Stones, Ureterocele, Ureteropelvic Junction (UPJ) Obstruction, Urethral Stones, Urethral Stricture, Urinary Retention, Urinary Tract Infection, Varicocele, Vesicoureteral Reflux, Vesicoureteral Reflux (bilateral), Vesicoureteral Reflux (nephropathy), Vesicoureteral Reflux (unilateral)
  • CHOC Children's Urology Practice Profile
    Provides a one-sheet resource of commonly treated conditions, services offered, location and contact information for referrals. For more comprehensive information, please see the Referral Guidelines.
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Children's Hospital of Orange County is affiliated with UC Irvine Healthcare and UC Irvine School of Medicine

CHOC Children's - 1201 W La Veta Ave, Orange, CA. Phone: 714-997-3000. .