Mohs Micrographic Surgery and other Dermatologic surgical needs

To refer a patient to any of our dermatologic surgeons, please:

  • Fax this form , the patient's chart notes and pathology report to 503-346-8103 (fax)
  • If you would like to check on available dates or schedule the appointment for your patient, call 503-494-6483 (voice)
  • Send the pathology slide with a copy of the pathology report to:
    OHSU Department of Dermatology
    Dermatopathology – CH5D
    3303 SW Bond Ave
    Portland, OR  97239
You may also email our office directly at to attach photographs

We are flexible and will work with either the referring physician or the patient to schedule appointments.

Please note:
All melanoma pathology reports and slides must be received and reviewed prior to date of surgery.

Mohs Surgeons Anna Bar, MD and Justin Leitenberger, MD