Refer Your Patient

309-308-2000

Complete records are essential in determining the urgency of referrals. Records to be sent include:

• Refer by fax (PDF)
• Any office notes, labs, or X-rays that pertain to the referral
• Any past hospitalizations that pertain to the referral

OSF Autism Pathways

EPIC: REF834
309-624-4830

OSF Autism Pathways does not provide diagnostic evaluations or therapeutic services.

• Refer online or refer by fax (PDF) – fax completed form to 309-624-2833

Once the referral is received, our navigators will contact the patient and address the family’s questions and concerns before connecting them to local resources that will meet their needs.

This may include connecting them to options for diagnostic evaluations, therapeutic interventions and additional autism supports.

Patients do NOT need a diagnosis of autism to be referred.

Peoria, Bloomington, Urbana, Moline, Ottawa or Springfield
(309) 655-3453

Rockford, Sterling, Sycamore, Freeport or Dixon
(815) 227-5600

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF)
• Copy of Insurance Card
• All pertinent test results

Follow up to referring physician office includes a Phone call and letter with appointment date and time.

309-624-9595

After submitting your referral, please call us at  as soon as possible for next steps.
Calls are answered 24/7 at 309-624-9595.

• Refer online or refer by fax (PDF)

309-624-6565

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer by fax (PDF) – fax completed form to 309-624-5567
• Sweat Test results
• Any genetic testing results
• Growth Chart

A nurse will contact the referring physician by Phone to confirm the appointment.

309-681-6960

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF)
• Growth Charts
• Developmental information i.e. developmental surveillance & screening
• MRI of brain (if done)

Follow-up to the referring physician office includes a Phone call, letter at the time appointment is scheduled, and report mailed following the evaluation.

Other instructions: Please be specific about reason for referral. Specify what areas of delay you are concerned about. Please indicate if autism is a question, and we will assist you with the referral process.

309-624-2480

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF)
• Labs and all pertinent test results done

Follow-up to referring physician office includes:

• Referrals are to be reviewed within the same day, or urgent cases need to be discussed with the peds endo on-call MD.
• Following the appointment, our office will send office visit notes to the referring physician office.

844-550-2553 

Epic: REF983

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF)

Follow up to referring physician office includes a Phone call and letter with appointment date and time.

309-655-4180

Complete records are essential in determining the urgency of referrals.Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF)
• Dates of treatment
• Lab / x-ray results
• Name of responsible party to contact for appointment

Our office will fax information to the referring physician office regarding the appointment time we have given to the patient. Following the appointment, the referring physician will receive correspondence from our physician by mail.

309-624-9844

Complete records are essential in determining the urgency of referrals. Please make sure to include the required records as our office is unable to schedule patients until we have the following information:

• Refer online or refer by fax (PDF) – fax completed form to 309-655-4147
• Pertinent Physician Notes
• Growth Charts
• Pertinent Labs

For suspected/new onset Diabetes, please place a referral to the Pediatric Diabetic Resource Center (PDRC) and call to discuss the case with the on - call Provider.

Our office will then call and offer the patient/family an appointment.

309-624-9844

Complete records are essential in determining the urgency of referrals. Please make sure to include the required records as our office is unable to schedule patients until we have the following information:

• Refer online or refer by fax (PDF) – fax completed form to 309-624-7609
• Pertinent Physician Notes
• Pertinent Imaging (KUB, UGI etc)
• Pertinent Labs

After receiving the required information, a referral specialist will call the patient with the first available new patient appointment.

Once an appointment is scheduled, new patient paperwork is mailed to the patient.

309-624-9680

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF) – fax completed form to 309-624-9524
• Any genetic testing results
• Growth Chart
• Family History
• Pregnancy History

When the appointment is scheduled, the referring physician office will receive a fax with the appointment information. In addition, an appointment card, driving directions, and patient information form will be mailed to the patient.

309-624-9680

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF) – fax completed form to 309-624-7778
• Copy of Insurance Card
• All pertinent test or lab results

Follow-up: Follow up to referring physician office includes fax or Epic notification when scheduled and office note after the appointment is completed.

309-624-9844

Complete records are essential in determining the urgency of referrals. Please make sure to include the required records as our office is unable to schedule patients until we have the following information:

• Refer online or refer by fax (PDF) – fax completed form to 309-655-4147
• Pertinent Physician Notes
• Growth Charts
• 2 out of 3 of the Following Labs Within the Last Year (Fasting CMP, Fasting Lipid Panel, Hemoglobin A1C)

Our office will then call and offer the patient/family an appointment.

309-624-4945

To schedule a consult at The Jim and Trudy Maloof St. Jude Affiliate Clinic at OSF Children's Hospital, please call us weekdays 8am - 4:30pm. Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF)
• Copies of all relevant laboratory and imaging studies
• All pertinent medical records

309-624-9680

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF) – fax completed form to 309-624-7778
• Any labs, x-rays, testing related to referral
• Pertinent Physician notes

We will contact your office by Phone or will send a letter with our findings.

309-624-9844

Complete records are essential in determining the urgency of referrals. Please make sure to include the required records as our office is unable to schedule patients until we have the following information:

• Refer online or refer by fax (PDF) – fax completed form to 309-624-3265
• Pertinent Physician Notes
• Pertinent Imaging (Renal Sonos/duplex/x-rays)
• Medication List
• Pertinent Labs

After receiving the required information, a referral specialist will call the patient with the first available new patient appointment.

Once an appointment is scheduled, new patient paperwork is mailed to the patient.

We are now accepting referrals for the following conditions:

• Seizure like activity
• Syncope
• Tics 
• Headaches (5yrs and above)

FAX FORM TO: 309-624-2668
309-624-9844

Complete records are essential in determining the urgency of referrals. Please make sure to include the required records as our office is unable to schedule patients until we have the following information:

• Refer online or refer by fax (PDF)
• Pertinent Physician Notes
• Test Results (CT, EEG, MRI)
• Pertinent Lab Results

If a patient is being referred for staring spells, seizures, or seizure like activity please order a sleep – deprived EEG to be completed prior to patient’s appointment when possible.

Our office will then call and offer the patient/family an appointment.

309-683-7600

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. For new patients not repaired by Children's Hospital surgeons in the past 5 years, records to be sent should include:

• Refer by fax (PDF) – fax completed form to 309-683-5855
• Radiographic Testing
• Referring physician notes with reason for referral and signs/symptoms/studies

Our office will contact the patient's family to be sure that correct instructions have been given.

A physician consult note will be sent to the referring physician once the patient is seen by the specialist.

309-308-3500

Our pediatric ophthalmologists provide comprehensive eye care services to infants, children and adolescents.

• Refer online or refer by fax (PDF)
• Please include referring diagnosis with referral.
• Referrals for patients with Retinopathy of Prematurity (ROP) must have documented medical records indicating that ROP is complete submitted with the referral in order to be scheduled for an appointment.

309-655-7668

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF)
• Radiology results including CT scans, MRI's
• Therapy notes
• Pertinent physician notes
• All pertinent lab results

Other instructions: Please send a CD, films or electronically push x-rays, and MRIs completed at facilities other than OSF.

309-624-9844

Complete records are essential in determining the urgency of referrals. Please make sure to include the required records as our office is unable to schedule patients until we have the following information:

• Refer online or refer by fax (PDF) – fax completed form to 309-655-4147
• Pertinent Physician Notes/All Pertinent Diagnosis

Our office will then call and offer the patient/family an appointment.

309-681-6960

Complete records are essential in determining the urgency of referrals.Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF)
• Whether or not the child is seeing a counselor

309-624-2277

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF)
• Pertinent Physician notes

309-624-9781

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer by fax (PDF) – fax completed form to 309-624-9733
• Any mental health information

Our secretary will contact the family within one business day of receiving the referral in order to schedule an intake appointment with our case coordinator.

Once the parent attends the intake, appropriate referrals will be made. We will inform your office of the specifics of the referrals and any known appointment dates with mental health providers. We will provide ongoing communication through Phone calls/letters regarding patients' attendance, participation and discharge information.

The Special Needs Resource Center provides resources for organizations and medical professionals across the state of Illinois looking for consultation and guidance for proper car seat usage for patients with special needs. Consultations can be over-the-phone or in person at our main location at the Children’s Hospital of Illinois in Peoria, IL or at our office in LaRabida Children's Hospital in Chicago, IL.

A referral includes:

• Resources and guidance for parents or guardians who have children that need special needs car seats
• Proper selection, installation and fitting of special needs adaptive restraints
• 2-month loan program for those in need (patients must be in the process of obtaining a permanent seat through their insurance when the referral is completed)

Refer online. For questions regarding the referral contact the resource center at 1-877-277-6543.

Records sent should include:

• Referring physicians notes with reason for referral
• Patient diagnosis
• Verification that a letter of medical necessity has been sent to the patients insurance company

309-655-3800

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. For new patients that have not had surgical intervention by Children's Hospital surgeons in the past 5 years, records to be sent should include:

• Refer online or refer by fax (PDF)
• Medical/surgical history, including outpatient notes
• Labs, radiology reports
• Copies of films

CDH patients repaired by our surgeons at Children's Hospital will have a post-op appointment prior to CDH clinic. At that time, our office will arrange CDH follow-up.

309-624-5100

Complete records are essential in determining the urgency of referrals. Please make every effort to have records sent to our office prior to the New Patient Appointment. Records to be sent include:

• Refer online or refer by fax (PDF)
• Office visit notes
• Urological operative reports
• Any renal & bladder ultrasound, VCUG, and KUB reports
• All urinalysis and urine culture reports

The patient will be called to schedule the appointment. The referring physician office will receive a fax with appointment information.