Online Referral Portal

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.

Adolescent Medicine

Allergy & Immunology

Cardiology

  • CHOC Specialists Cardiology 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.

Endocrinology

  • CHOC 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 Specialists Endocrinology Referral Request Form
    General Endocrinology Clinic, Growth Clinic, Diabetes Clinic
  • CHOC 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

 Metabolic Disorders

  • CHOC Specialists Metabolic Disorders Referral Guidelines
    Developmental Regression / Cognitive Impairment, Hypotonia, Stroke-like Episodes, Intermittent Ataxia, Altered Mental Status, Medically Refractory Seizures, Failure to Thrive / Cyclic Vomiting, Recurrent Hypoglycemia, Abnormal Laboratory / Imaging Findings, Family History of Inborn Errors of Metabolism / SIDS, Positive Newborn Screening for Metabolic Disorders, Urea Cycle Disorders, Organic Acidurias, Amino Acid Disorders, Vitamin and Cofactor Disorders, Carbohydrate Metabolism Disorders, Fatty Acid Oxidation Disorders, Mitochondrial Disorders, Neurotransmitter Disorders, Lysosomal Storage Diseases. Peroxisomal Disorders, Creatine disorders, Purines & Pyrimidines disorders, Congenital Disorders of Glycosylation (CDG)
  • CHOC Specialists Metabolic Disorders Practice Profile
    Provides a one-sheet resource of commonly treated conditions, services offered, location and contact information for referrals.

Neonatology

Nephrology

Neurology

Neurosurgery

Ophthalmology

  • CHOC Ophthalmology Referral Guidelines
    Visual Behavior/Acuity, Eyelids, Nasolacrimal System, Anterior Segment, Ocular Media Opacieties, Sensorimotor System, Prematurity, Systemic Disorders, Congenital Syndromes, Non-Accidental Injury, Headaches
  • CHOC Specialists Ophthalmology Referral Request Form
    Childhood glaucoma (infantile, juvenile and traumatic), Double vision (diplopia), Droopy eyelids (ptosis), Eye inflammation (uveitis), Infantile and childhood cataracts, Nasolacrimal duct obstruction (blocked tear ducts), Refractive errors (need for glasses/contacts), Retinopathy of prematurity and its complications, Strabismus (crossing or drifting of the eyes). Tearing eyes, Traumatic eye injuries.
  • CHOC Ophthalmology Practice Profile
    Provides a one-sheet resource of commonly treated conditions, services offered, location and contact information for referrals.

Orthopaedics

Otolaryngology

Pediatric General and Thoracic Surgery

Plastic Surgery

Pulmonology

Radiology

Rehabilitation Services

Rheumatology

Urology

  • CHOC Urology Center 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 Urology Center Referral Request Form
    Download a PDF of the CHOC Urology Center Referral Request Form
  • CHOC Urology Center 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.