Please click on the type of patient referral you need to download a printable form. Each form should be faxed to the corresponding department fax number.
To expedite the referral process, please send demographics, insurance, all prenatal records/lab results, prior ultrasounds and the appropriate signed order form for each. Also, please note that insurance companies require the ordering physician’s office to request procedure authorizations.
Fetal Care Center
For comprehensively supportive care for any patient with suspected or confirmed fetal diagnosis
Maternal-Fetal Medicine/ OB Ultrasound
For traditional care for privately insured patients with maternal indication
High-Risk OB Clinic, Teen Pregnancy Center or the Center for Diabetic Pregnancy
For comprehensively supportive, safety net care for publicly insured and uninsured patients with maternal indication
Washington University Genetic Counseling
For pregnancies with advanced maternal age or abnormal maternal serum screening
St. Louis Children’s Hospital Fetal Heart Center
For family or sibling history of heart defect, maternal diabetes
For emergent maternal transport with our Maternal-Fetal Transport Team, or an urgent telephone consult with a Maternal-Fetal Medicine or Fetal Care specialist, please call Women’s Direct at 855.747.5300.