Clinical Telehealth Program - Pediatric Specialties
Neuromuscular Disease Medicine
Otolaryngology (Cleft & Craniofacial)
Psychology - Medical Health & Behavior
Psychology - Mental Health & Evaluations
*Offered by contract only. For contracted services or specialties not listed, please contact Candace Sadorra, UCD Health System Clinical Telehealth Program Manager, at (916) 734-4243 or email@example.com. To download a list of specialties, please click here.
Referring and Scheduling
- Complete a Telehealth Referral Request Form and fax it to (866) 622-5944 along with any documentation oulined in the referral guidelines (see "Pediatric Specialties" section, above left, for specific guidelines). For specialties not listed, please provide as much documentation as possible to assist us in securing a one-time consultation, though this is not always possible depending on departmental staffing and resources.
- A Telehealth coordinator will call you to schedule your appointment, and/or request additional information, if necessary. We will also provide you with the IP address to dial for your consultation. We ask that all sites test the connection prior to the appointment date to ensure good audio/visual quality and review the use of any external telehealth peripherals that might be needed during the consultation.
- Please remember to confirm the appointment with your patient two business days prior to the date of the consultation.
- On the day of the appointment, please provide your patient with a copy of our Notice of Privacy Practices and fax a signed copy of our Acknowledgement of Receipt form to (866) 622-5944 prior to beginning the consult. Document your patient's verbal consent to participating in a telehealth consultation in your patient's chart/electronic record.
- Do's and Don'ts for a Remote Site (PDF)
- ENT Questionnaire (PDF)
- Notice of Privacy Practices (PDF)
- Notice of Privacy Practices [Spanish] (PDF)
- Notice of Privacy Practices: Acknowledgement of Receipt (PDF)
- Patient Satisfaction Survey (PDF)
- Provider Satisfaction Survey (PDF)
- Telehealth Referral Request Form (Microsoft Word)
UC Davis Health System
Center for Health & Technology
Clinical Telehealth Program
4610 X St, Suite 2301
Sacramento, CA 95817
Phone: (877) 430-5332
Fax: (866) 622-5944
Candace Sadorra, Clinical Telehealth Program Manager
Telephone (916) 734-4243
Sashi Bandhu, Clinical Telehealth Coordinator
Telephone (916) 734-4735
Julie Rossi-Otremba, Clinical Telehealth Coordinator
Telephone (916) 734-4750
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