e-Consult a Pediatric Specialist

Who is e-Consult intended for?

Health care providers outside of the local service area for Children's Hospital. e-Consult is not intended to be used by the general public, parents/guardians or families. If you are a parent/guardian or family member and would like your child's condition reviewed, please have your child's primary care doctor or specialist submit the e-Consult form below.

Why e-Consult?

Pediatric specialists at Children's Hospital offer the e-Consult program to:

Address the shortage of pediatric specialty health care professionals outside of the New Orleans area
Reduce barriers to care caused by distance and limitation on transportation
Reduce the likelihood that a patient would otherwise delay or forego care
Increase access to educational materials and services
Increase opportunity for physicians to collaborate with pediatric specialists that they may not otherwise have access to
Help control health care costs while enabling health care professionals to provide quality, up-do-date services to their patients

The e-Consult process:

Step 1: Once an e-Consult form is submitted, the e-Consult Clinical Team will review the request and create an electronic request for an e-Consult with the most appropriate pediatric specialist at Children's Hospital.

Step 2: The pediatric specialist will review the forms and medical records that were submitted by the referring provider.

Step 3: The pediatric specialist or the e-Consult Clinical Navigation Team will respond to the referring provider by either secure email or by a phone call with information on possible advisory opinion, recommended care and next steps.

Most e-Consults are completed in 24-72 hours, excluding weekends and holidays.

If you have further questions please call Liz Milligan at 504.894.6778 or Gretchen Dondis at 504.895.5655 or email CHNOconcierge@lcmchealth.org.

Submit an e-Consult using the form below:

Is this patient case currently in or anticipated to be in litigation? Please note if you select yes, we will be unable to review this case.
- Yes
- No
Please make a selection.
Patient Information
Parent or Guardian's First Name:

Please enter the parent or guardian's first name.
Parent or Guardian's Last Name:

Please enter the parent or guardian's last name.
Patient's First Name:

Please enter the patient's first name.
Patient's Last Name:

Please enter the patient's last name.
Patient's Date Of Birth

Please enter a date.
Email Address

Please enter an email address.
Patient's Gender:
- Male
- Female
Please make a selection.
Address

Please enter your street address.
Address 2
City

Please enter your city.
Select State

Please enter your state.
Zip Code

Please enter your zip code.
Contact Phone

This isn't a valid phone number.

Please enter your phone number.
Secondary Phone

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Provider Information
Provider's Name

Please enter your provider's name.
Provider's Email Address:

This isn't a valid email address.

Please enter your provider's email address.
Provider's Phone

This isn't a valid phone number.

Please enter your provider's phone number.
Provider's Fax

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Preferred Method of Contact (Note: If phone call or fax is selected, numbers provided above will be used. If email is selected you will receive an email at the address provided above stating you have received an encrypted message with instructions to sign in with a one-time pass-code to access the secure email.)

Please make a selection.
Is a provisional diagnosis known?
- Yes
- No
Please make a selection.
If yes, please describe the patient’s working diagnosis:
Pertinent past medical history:
Sub-specialties already seen:
Any prior hospitalization? If so, please describe:
Specific questions or concerns for e-Consult:
File Upload

E-Consult Disclaimer

The Children's Hospital affiliated pediatric specialty physicians providing this service do not have the same information that is obtained by examining the patient and obtaining a history and physical assessment. Therefore, the physician may not be aware of some facts that would otherwise affect his or her opinion of the diagnosis. By requesting an e-consult, you acknowledge and agree to assume the risk of this limitation.

By requesting an e-Consult through this website, you acknowledge and agree that:

The advisory consultation and/or recommendation is limited and provisional;
The consultation is not intended to replace a full medical evaluation with a physician;
The physician(s) performing the e-Consult does not have the benefit provided by a direct physical examination.

By engaging our services, you acknowledge and agree to solely assume the risk of these limitations, you further understand that no warranty or guarantee has been made concerning any particular advisory consultation, result or cure of the patient's condition.

Use of this service does not oblige the provider to refer to Children's Hospital in New Orleans or any affiliated provider.

e-Consult a Pediatric Specialist

Who is e-Consult intended for?

Why e-Consult?

The e-Consult process:

Submit an e-Consult using the form below:

Patient Information

Provider Information