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Ambulatory Services

Referring Patients to Children’s Specialty Clinics

We believe that referring community providers and Children’s providers are partners in the care of patients. We encourage families to coordinate with their primary care pediatrician or family physician when coming to Children’s specialists.

Children’s Ambulatory Services encompass more than 30 different specialties, with additional subspecialty clinics offered at the hospital and the regional locations.

Children’s new state-of-the-art Ambulatory Care Building was designed to improve the care and service we provide to you and your patients and families.

When you refer patients to Children’s please give families one of the "When Your Child is Referred to Children’s" sheets which guides families through our appointment making process.

They are available in the following languages:

Requesting Specialty Services at Children’s

You may request new specialty appointment electronically, by phone or by fax.

Making a Referral Electronically (eReferral)

eReferral is found on the Children’s Care Gateway, on the Medical Staff Web site. Complete information about getting started, as well as other help resources, are on the Gateway. Electronic referrals are the fastest way to send your patients' referrals to Children’s; once sent, they immediately appear in our referral system. Please be sure to complete all fields and include as much information as possible about the questions you have about your patient.

Please fax supporting clinical information to:

  • 206-985-3121
  • 866-985-3121 (toll free)

Do NOT fax clinical information directly to the clinic or specialty.

Phoning in a New Referral/Consult Request

  • 206-987-2080, option 1
  • (toll free) 866-987-2080, option 1

Your call will be answered by a clinical intake nurse who will collect brief demographic and clinical information. The nurse may request that you fax additional clinical data to optimally prepare for the appointment.

For some conditions, our clinics may require a more detailed triage to ensure referral to the most appropriate provider.

Please refer to the Consult and Referral Guidelines for information about tests and treatments that are recommended prior to referring patients to Children’s in order to make your patient's visit most meaningful.

Faxing in a New Referral/Consult Request

  • 206-985-3121
  • 866-985-3121 (toll free)

The New Appointment Request Form (PDF) (Word version, DOC) is used for new referrals to Children’s specialty clinics.

It is completed by the referring physician, and helps ensure that we have the information we need to best schedule appointments and coordinate care. Please include all requested information in order to expedite the request.

Please fax relevant clinical information with the NARF to ensure appropriate scheduling and for coordinating care between you and Children’s providers. 

Once an appointment is scheduled, you will receive a fax with the date and time for which the appointment has been scheduled.

A consulting nurse will review the referral form, and will contact you with any questions or to request additional clinical data to optimally prepare for the appointment.

If your office has its own referral form, it may be used in place of the NARF if it contains the same information. However, we believe that appointments will be scheduled more quickly and more conveniently for your office, your patients and for Children’s if the NARF is used.

This fax number is a dedicated line and only goes to the referral staff.

Additional NARFs may be downloaded or duplicated in your office.

Consult or Referral?

To meet requirements of the Centers for Medicare and Medicaid Service (CMS), please specify whether your request for specialty care is for a consult or a referral (transfer of care).

According to CMS, a consult has three components: a question with a request for a response, a face-to-face evaluation, and the actual response to the requesting provider.

A referral indicates that you would like to transfer all or part of your patient’s care to a Children’s provider.

New Appointment Request Form (NARF) includes both options; please select the one that applies to your request. The correct designation allows Children’s to appropriately bill for services and avoid fines for billing inappropriately.

By the CMS definition, a referral, also known as a transfer of care, only applies to a small number of our new patient visits, such as when a patient moves into our area and is referred to a clinic for care of a chronic health issue.

What Patients and Families Can Expect

Once we receive the completed request, the family may call the clinic directly to schedule the appointment. Generally this can occur within one business day after the referral has been sent or called in from your office.

To reach the clinic scheduler, the family may call Children’s at 206-987-2000 or toll free 866-987-2000, and ask for the specific specialty clinic's appointment line.  The information sheet "When Your Child is Referred to Children’s" has more specific appointment phone numbers.
If the family hasn't called after 2 weeks, you will be notified that your patient has not been scheduled.

Families will receive a reminder phone call for their appointment and also receive a written confirmation of the appointment in the mail for appointments scheduled more than 3 weeks out.

Urgent Referrals

If you have a request that needs more immediate attention, please call the provider on-call for the specific specialty through the physician operator at 206-987-7777.

Referrals to Multiple Clinics

If your patient needs appointments with multiple clinics, they can be listed on the same NARF. Be sure to include the relevant clinical information for each specialty clinic.

Insurance Authorization Forms

Some health plans, including Molina and Group Health, still require advance authorization.

Insurance authorization is a separate process that requires the use of the individual health plan's authorization form.

Those forms should be faxed to Children’s Insurance Processing Department at 206-985-3297.

No Shows and Late Arrival Policy

If a patient is more than 20 minutes late to an appointment, clinic staff may ask to reschedule the appointment in order to honor commitments to other families.

After 3 clinic no-shows, patients will be returned to the care of their PCP.

This will be enforced at the discretion of the Children’s specialist who will communicate with the PCP prior to notifying the patient's family.

Repeat last-minute cancellations (notice of less than 24 hours) may qualify as no-shows.

Consult and Referral Guidelines

Consult and Referral Guidelines are created to assist referring physicians in the evaluation and management of pediatric patients.

Developed by Children’s 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 and the guidelines that are currently available. Updates, as well as additional specialties and diagnoses, are added regularly.

  • ACCESS: Long-term Follow-up Clinic for Cancer Survivors (PDF)
  • Adolescent Medicine (PDF)
    • Adolescent Behavioral Medicine
    • Adolescent Reflux Neurovascular Dystrophy
    • Biofeedback
    • Chronic Fatigue
    • Chromatic Somatic Complaints
    • Eating Disorders
    • Male Health
    • Overweight
    • Pediatric and Adolescent Gynecology
  • Audiology (PDF)
    • Hearing loss, suspected or known
    • Severe to profound bilateral sensorineural hearing loss
    • Permanent bilateral hearing loss
  • Behavioral Medicine (PDF)
    • Anxiety and Obsessive-Compulsive Disorder
    • Attention Deficit Disorder (ADD)
    • Depressive Disorders in Children and Adolescents
    • Eating Disorders in Adolescents: Anorexia and Bulimia
    • Oppositional Defiant Disorder, Conduct Disorder, aggression and other disruptive behavior problems
    • Psychosis
  • Dentistry (PDF)
    • Dental Abscess (Emergent) in a Healthy Child
    • Dental Trauma (Emergent) in a Healthy Child
    • Extensive Dental Caries (Non Emergent) in a Healthy Child
    • Dental Caries in a Child with Mild to Moderate Medical Conditions or Developmental Disabilities
    • Dental Caries in a Child with Major Medical Conditions or Developmental Disabilities
    • Malocclusion in Patients with Cleft Palate or Craniofacial Syndromes
    • Major Facial Trauma and/or Jaw Fracture
    • Oral Lesions, Cysts and Tumors
    • Complex Surgical Dental Extractions
    • Surgical Management of Clefts or Craniofacial Anomalies
    • Surgical Management of Severe Jaw Length Discrepancies
    • Temporomandibular Joint or Muscle Dysfunction
  • Dermatology (PDF)
    • Acne
    • Herpes Simplex, Herpes Zoster and Varicella
    • Impetigo and Pyoderma
    • Inflammatory Dermatoses
    • Keloids/Hypertrophic Scars
    • Molluscum Contagiosum
    • Pre-Cancerous Skin Lesions and Skin Cancers
    • Psoriasis
    • Vascular Lesions
    • Wart Treatment
  • Endocrinology (PDF)
    • Growth Disorders
      • Short Stature
      • Tall Stature
    • Obesity
    • Pubertal Disorders
      • Precocious Puberty
      • Early Childhood Breast Development
      • Delayed Puberty
      • Premature Menses
    • Thyroid Disorders
      • Congenital Hypothyroidism
      • Acquired Hypothyroidism (Hashimoto's Thyroiditis)
      • Neonatal Hyperthyroidism
      • Acquired Hyperthyroidism (Grave's Disease)
    • Goiter
  • Gastroenterology Endoscopy/Colonoscopy (PDF)
    • Chronic Abdominal Pain
    • Chronic, Non-Bloody Diarrhea
    • Bloody Stool
    • Gastro Esophageal Reflux
    • Failure to Thrive
    • Vomiting with or without Abdominal Pain
    • Referral Sources for Constipation
    • Referral Sources for Encopresis
  • General Surgery (PDF)
    • Gastroesophageal Reflux
    • Inguinal Hernia
    • Pectus Excavatum
    • Perirectal Abscess
    • Pilonidal Cyst/Abscess
    • Surgical Constipation
    • Umbilical Hernia
  • MRSA (PDF)
  • Nephrology (PDF)
    • Chronic Kidney Disease
    • Hematuria
    • Hypertension
    • Nephrotic Syndrome
    • Proteinuria
  • Neurodevelopmental (PDF)
    • Cerebral Palsy
    • Developmental Delay
    • Prenatal Counseling
    • Spasticity Management Clinic
  • Neurology (PDF)
    • Headache
    • Febrile Seizures
    • First Afebrile Seizure
    • Mitochondrial
    • Recurrent Unprovoked Seizures (Epilepsy)
    • Intractable Epilepsy
  • Nutrition (PDF)
    • Adolescent Wellness Clinic
    • Child Wellness Clinic
    • Eating Disorders Services
    • Endocrinology Clinic
    • Gastroenterology Clinic
    • Growth and Feeding Dynamics Clinic
    • Ketogenic Diet
    • Lipid Clinic
    • Nutrition Clinic
    • Adolescent Nutrition
    • Occupational and Physical Therapy
    • Speech and Language Therapy
  • Ophthalmology (PDF)
    • Abnormal Pupil
    • Decreased Visual Acuity
    • Droopy Eyelid/Ptosis
    • Lid Swelling
    • Eye Turns In (Esotropia)
    • Eye Turns Out (Exotropia)
    • Acute Onset of Esotropia
    • Hemangioma located around the eye
    • Increased Tearing (Nasal Lacrimal Duct Obstruction)
    • Red Eye or "Pink Eye"
    • Stye or Chalazion
  • Orthopedic (PDF)
    • Extreme Pain or Limping or Non Ambulation
    • Acute Fracture at any anatomic site
    • Hip Pain (or knee pain referred from hip)
    • Bone Infection or Osteomyelitis
    • "Compartment Syndrome" or Severe Traumatic Leg or Arm Pain
    • Soft Tissue Mass or Soft Tissue Sarcoma - Desmoid Lipoma, Hemangloma, Soft Tissue Abscess/Hematoma
    • Benign Bone Tumors
      • Non-Ossifying Fibroma
      • Benign cyst or unicameral benign cyst
      • Aneurysmal bone cyst
      • Eosinophilic Granuloma
    • Malignant Bone Tumors
      • Osteosarcoma
      • Ewings Sarcoma
    • Clubfoot
    • Flatfeet
    • Bunions
    • Toe Walking
    • Metatarsus Adductus (Intoeing from the foot)
    • Knee Sprain or Ligament Injury
    • "Locked Knee"
    • Bowlegs (possible Blount's Disease)
    • Knee Pain Chronic
    • Developmental (Congenital) Dislocation of the Hip (DDH)
    • Hip Dysplasia
    • Slipped Capital Femoral Epiphysis (SCFE) Severe Hip Pain Physeal Fracture of Femoral Head
    • Legg Perthes Disease or Legg Calve Perthes or Perthes Disease
    • Scoliosis or Spinal Curvation
    • Back Pain other diagnoses
      • Septic Discitis
      • Vertebral Osteomyelitis
      • Spinal Tumors or Herniated Discs
      • Vertebral Fractures
      • Musculoskeletal Pain
    • Spondylolysis and Spondylolisthesis (stress fracture of lower back)
    • Scheuermann's Kyphosis
    • Skeletal Dysplasia
    • Torticollis
  • Otolaryngology (PDF)
    • Allergic Rhinitis
      • Nasal Allergies
    • Ciliary Dyskinesia
    • Cough
    • Epistaxis
    • Hearing Loss
    • Hoarseness
    • Laryngomalacia (or infantile stridor)
    • Neck Mass
      • Lateral Neck Mass
      • Midline Neck Mass (possible thyroglossal duct cyst)
      • Thyroid Mass
    • Nasal Fracture
    • Otitis
      • Chronic Otitis Media
      • Recurrent Otitis Media
      • Otitis Externa ("Swimmer's Ear")
    • Tonsils
      • Large Tonsils and/or adenoids with obstructed breathing during sleep
      • Recurrent tonsilitis
    • Rhinorrhea/Congestion
    • Sinusitis
    • Vascular Tumor or Anomaly
    • Velopharyngeal Insufficiency
    • Vertigo/Dizziness
  • Pain (PDF)
    • Abdominal Pain
    • Acupuncture
    • Back Pain
    • Chest Pain
    • Disease Process or Side Effects of Treatment
    • Facial Pain
    • Headache
    • Limb Pain
    • Musculoskeletal Pain
    • Neuropathic Pain
    • Opioid Dependence
  • Plastic Surgery (PDF)
    • Dermoid cysts of skull or face
    • Ear anomalies
    • Facial fractures
    • Lacerations
    • Lesions
    • Scars
    • Vascular Malformations
  • Prenatal (PDF)
  • Psychiatry and Behavioral Health (PDF)
    • Anxiety and Obsessive-Compulsive Disorder
    • Depressive Disorders in Children and Adolescents
    • Eating Disorders in Children and Adolescents
    • Treatment Resistant ADHD
    • Oppositional Defiant Disorder/Behavioral Disorders
  • Pulmonary (PDF)
    • Asthma, Recurrent Cough or Wheeze
    • Bronchopulmonary Dysplasia, Chronic Lung Disease
    • Cystic Fibrosis
    • Sleep Disorders
  • Rheumatology (PDF)
    • Swollen joint(s), painful joints
    • Possible SLE
    • Dermatomyositis, Muscle Weakness
    • Vasculitis
    • Fevers of Unknown Origin
    • Raynaud's
    • Scleroderma Syndromes
  • Urology (PDF)
    • Phimosis
    • Urinary Tract Infection
    • Voiding Dysfunction and/or Nocturnal Enuresis

You can also request a copy of the initial Consult and Referral Guidelines via our Health Care Provider Materials Request Form (PDF).

Medical Disclaimer

Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication.

However, in view of the possibility of human error or changes in medical sciences, neither the authors nor CHCS nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from the use of such information.

Regional Clinics

In order to bring pediatric specialty care closer to home for patients and families, Children’s has established specialty clinics in Bellevue, Everett, Federal Way, Olympia and in the Tri-Cities.

Refer patients to the regional clinics using the same phone and fax numbers as above. To phone in a referral, call 206-987-2080, and 866-987-2000, ext 72080 (toll free), or fax the New Appointment Referral Form to 206-985-3121.

In addition, our specialists provide care in outreach services and via telemedicine throughout the Pacific Northwest.

Odessa Brown Community Clinic (OBCC) provides primary care for newborn and children to age 21.

After Hours Clinics

When your child needs urgent care, we're here. Appointments at the After Hours clinics, in Bellevue and Seattle, are arranged by your child's primary care doctor, or by Children’s consulting nurses.

Learn more about the services offered at the After Hours Clinic.