Liver Program Referral Process
We accept referrals via phone (801) 581-6795. Susan Osborne, our Transplant Assistant will help facilitate the initial evaluation.
Phone: (801) 581-6795
Toll-Free: (800) 824-2073 Extension 16795
Fax: (801) 585-5091
The following information, if available, will be requested at the time of referral:
- Patient demographics, including current insurance information
- Two years of Medical records from all attending physicians and specialists
- History and physical
- Lab work
- Radiology reports
- Pathology report, including liver biopsy if available.
- Surgery and procedure reports, including EGD, Colonoscopy, pap smear and mammogram, if applicable.
- If there is a history of drug or alcohol abuse, the patient will need to provide documentation of six months of attendance in a relapse prevention program, i.e. alcoholics anonymous, or private inpatient or outpatient treatment and results of six months of random drug and alcohol screens from referring physicians.
- Immunization records
- A letter from your dentist stating that all dental work has been completed and that no further dental treatment, other than teeth cleaning should be required for one year.
University Health Care
Liver Tranplant Program
50 North Medical Dr., PA455
Salt Lake City, Utah 84132