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Aerodigestive Program Referrals

Physicians or parents can refer a child to our program.

To make a referral, please follow these instructions and FAX all documents below at the same time (to keep records and forms together) to:

205-638-2078 Attn: Ashley Chapman – Aerodigestive.

  1. A completed Request for a Specialty Clinic Appointment form (PDF)
  2. Any required insurance approval referral forms completed from your insurance company (Medicaid, Blue Cross Blue Shield, etc.).

Once the referral is received, your child's medical history will be discussed at our joint Aerodigestive conference meeting and a care plan is developed. Depending on your child's needs, we will schedule appointments with our feeding specialists (Speech and Language Pathology), Nutritionists or Pulmonology, Gastroenterology (GI) and Ear, Nose and Throat (ENT) doctors. Other appointments with specialists will be coordinated as needed.

Please email Ashley Chapman at ashley.chapman@childrensal.org or call her at 205-638-3447 with any questions.