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