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Doctors Entrance

REFERRAL FORMS

Referring through Children’s Direct

Children’s real-time online scheduling program, Children’s Direct, allows you to make specialty care appointments for your patient families before they leave your office. Your patients can choose from the next available appointments at specialty care offices and hospital-based clinics. Staff at Children’s will work with your office to verify insurance coverage and make sure pre-authorizations are received prior to the scheduled visit.

Children’s Direct requires a user name and password to log on. To schedule Children’s Direct training in your office, please call your physician liaison or the Communications department at 510-428-3367.

Referral Forms
Referral and other forms are available here in PDF form. The Patient Evaluation Form is a fill-in form when using Acrobat. To view and print PDF files you need Adobe's Acrobat Reader.

• Referral Form

• Emergency Department Referral Form

• Patient Evaluation Form

For help making a referral, please call Central Authorizations at (510) 428-3563.

To request a referral directory, contact the Communications department at (510) 428-3367.
Online Referral Directory

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