Plastic Surgery New Patient Supporting Documents for Plastic Surgery

Diagnosis /Symptom: Ear Anomalies, Facial Fractures, Lesions

What should the referring provider send?

1. Reason for visit
2. Please send any imaging studies (CT, MRI) that have been done.
3. Biopsy reports and slides must accompany requests for re-excision of lesions biopsied elsewhere.
4. No pre-referral work-up is required for most conditions.

Diagnosis /Symptom: Cranial Facial

What should the referring provider send?

1. Reason for visit
2. No pre-referral work-up is required for most conditions.
3. Clinic notes relevant to referral, including information such as:
   Head circumference
   Description of head shape
   Imaging studies (CT, MRI, X-rays)