Please complete the form below and a National Jewish Health physician will respond to your consult request as soon as possible, usually within three business days.
You may also contact our Physician Line at 1.800.652.9555, Monday - Friday, 8:00 am to 5:00 pm Mountain Time or physicianline@njhealth.org.
For mycobacterial disease consultations, complete the Mycobacterial Referral/Consult form.
Other resources: COVID-19 Testing Referral | Refer a patient | Order a test | Radiology Consult
Provider Information
International Address
International Phone Number
Patient Information
Primary Diagnosis
Severity
Other medical problems
Onset of symptoms and course of illness (including complicating factors)
Related lab and imaging results
Medications
Smoking history
Questions for National Jewish Health's consulting physician
Comments
PLEASE NOTE: Our system does not accept attachments. If you attempt to attach a document, the information will not be processed.
There are some validation issues on this page and we are unable to save your answers. To continue to the selected page without saving this page press 'Continue'.