Endocrinology and Diabetes
Refer a Patient
How to Refer a Patient
Updated November 2019
We are accepting new referrals for both diabetes-specific and general endocrinology conditions.
General endocrinology conditions are currently experiencing longer-than-normal wait times. To improve access for patients, we are:
- Moving the Endocrinology outpatient clinic into the larger Sand Point Clinic on the hospital’s main campus in January 2020.
- Reviewing referrals daily. Our internal triage process identifies those patients who need to see a specialist most urgently.
- Actively recruiting and hiring new providers.
- Redirecting patients to primary care, when appropriate. For example, many patients referred for abnormal TSH levels, goiter, obesity, short stature and vitamin D deficiency can be well managed in primary care.
If you are unsure about whether to refer your patient, please call our Clinical Intake Nurses at 206-987-2080, option 1.
The information below is also found in our Algorithm for Newly Diagnosed Patients Age 17 or Younger (PDF).
If your patient meets any of the following criteria, they will require hospital admission for our two- or three-day inpatient protocol.
- Is four years old or younger
- Is in diabetic ketoacidosis (DKA)
- Is acutely ill
- Has complex medical or social needs
- Requires isolation procedures
- English is not the primary language spoken by the family
Please call Seattle Children’s Communication Center at 206-987-8899 or, toll-free, 866-987-8899, before sending your patient to Seattle Children’s. This helps facilitate their arrival in the Emergency Department.
For all other patients (i.e., five years old or older, otherwise healthy, no complex medical/social needs, English is family’s primary language), page the endocrinologist on call at 206-987-7777 to see if they are eligible for outpatient education. To determine your patient’s eligibility for outpatient education, please obtain the following before contacting Seattle Children's:
- Blood glucose
- Urine ketones
- If possible, please also get:
- Venous blood gas (VBG)
- Beta hydroxybutyrate (BOHB)
- Your patient may qualify for outpatient education if the child:
- Is at least five years old
- Is not in diabetic ketoacidosis (DKA)
- Does not have other complex medical or social needs
- Does not require isolation precautions
- Is not acutely ill
- Has an English-speaking family
- If your patient is in DKA, they will need to be admitted to the hospital for DKA management before diabetes education can occur. DKA is diagnosed as:
- Glucose greater than 200 mg/dL and
- pH less than 7.3 or HCO3 <15 mEq/L and
- Ketonemia (BOHB >1 mmol/L)
If your patient is eligible for outpatient education, we will likely see them at 7:30 a.m. the next day to start education. Please print the family handout Living With Diabetes: A 2-Day Class for Your Family (PDF), write in the outpatient appointment date and time and send it home with the family.
With outpatient education, patients and their parents attend a two-day workshop in a classroom setting. This works better for many healthy patients because they avoid having to spend a night in the hospital. This approach also improves access to inpatient medical beds for the region’s sickest children.
Please refer patients age 18 and older to an adult endocrinology provider.
We ask that providers submit a referral that is complete. A complete referral helps us schedule an appointment for your patient in a timely manner and match them with the right specialist and clinic location. It ensures a productive and smooth first appointment for your patient. It also helps us assess the needs of our community and plan to have capacity to meet those needs.
We will not schedule patients until a complete referral is received when the referral is for the following conditions:
- Short stature
Please submit all relevant documentation and chart notes with your referral, including:
- Growth curves/charts
- Results from any relevant labs or studies
- Relevant imaging results (CT, MRI, X-rays). Please upload to PowerShare as well as faxing the report.
If you are referring a patient to the Prader-Willi Syndrome Clinic, we require genetic confirmation of Prader-Willi syndrome (PWS) and ask that you send all essential subspecialty, radiology and lab information.
Please note: We are seeing new patients through age 17 only, with exceptions for special circumstances (e.g., young adults with delayed puberty/hypogonadism and medically complex young adults who are being seen by other specialists here). If your patient is 18 or older, we ask that you refer them to an adult endocrinology provider.
Submit a referral
If you are referring a patient for newly diagnosed diabetes, please see “Patients newly diagnosed with diabetes” above.
If your patient has ongoing diabetes or other endocrine conditions, please follow the standard referral procedures below:
If your patient has ongoing diabetes or other endocrine issues, please note:
- We triage referrals and call the family when we have an appointment available.
- Patients are prioritized based on their current condition and acuity and the availability of a specialist to see them.
- We will notify you when an appointment is made.
- Your patient will be seen by the provider who is the best match for managing the current problem.
Please call our Clinical Intake Nurses if you need assistance: 206-987-2080, option 1.
We’re committed to partnering with referring providers
If we evaluate your patient and determine they do not have a condition that requires ongoing evaluation and management in a specialty setting, we will return them to primary care with an appropriate plan of care for the primary care provider.
We are always available to answer questions and support your care of your patients.
- Diagnosis and treatment options: call 206-987-7777 (Provider-to-Provider Line).
- Referring or transporting a patient to our Emergency Department or Urgent Care: call 206-987-8899 or, toll-free, 866-987-8899 (Emergency Department Communications Center).
- Questions about scheduling and referrals, including locating or expediting a referral: call 206-987-2080 (Clinical Intake Nurses).
Learn more about managing your patients at Seattle Children's.
Meet the Endocrinology and Diabetes team.
We have locations in Seattle, Bellevue, Everett, Federal Way, Olympia, Tri-Cities and Wenatchee. Our endocrinologists also see patients at a community clinic in Port Angeles, Washington. See our locations.
What Your Patients Can Expect
For patients newly diagnosed with diabetes, please see “Patients newly diagnosed with diabetes” above.
For other patients:
- Once we receive your referral, your patient will be in our queue to review and schedule. Many endocrinology services have a long wait.
- Families may call 206-987-2640, option 1, to ask to be added to a cancellation list.
- We review openings and the patient referral queue daily.
- As openings become available, we call families to schedule based on provider availability and the patient’s condition and acuity.
Resources for Providers
- Algorithm: Hypothyroid (PDF)
- Algorithm: Goiter (PDF)
- Pediatric Obesity – Assessment, Treatment and Prevention: An Endocrine Society Clinical Practice Guideline (Journal of Clinical Endocrinology and Metabolism)
- The Role of the Pediatrician in Primary Prevention of Obesity (AAP)
- Algorithm: Precocious Puberty (Breast Development/Testicular Enlargement, Hair Development, Vaginal Bleeding/Spotting) (PDF)
- Evaluation and Referral of Children With Signs of Early Puberty (American Academy of Pediatrics)
Vitamin D deficiency
- Algorithm: Vitamin D Deficiency (PDF)
- Vitamin D Deficiency in Children and Its Management: Review of Current Knowledge and Recommendations (AAP)
- Global Consensus Recommendations on Prevention and Management of Nutritional Rickets (Journal of Clinical Endocrinology and Metabolism)
To suggest resources from Seattle Children’s that would be useful to primary care providers, please email us.