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CONSULT REQUEST GUIDELINES
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Memory Impairment
Suggested Pre-Referral Evaluation and Management Guidelines
MMSE
Functional Evaluation
Screen for depression
Suggested Additional Test/Management Prior to Specialty Visit
TSH
Syphilis FTA
Comp, CBC
Head imaging
Patient Education/Information (includes preps)
Future planning
Advance Directives
Appointment Timeframe
2 weeks
How to Get Results to Consultant
UMHS Patients: See MiChart
External Patients: Patients hand carry outside records to visit
Clinic Contact Information
Physician: 800-962-3555
Patient: 734-764-6831
Clinic Location Sites
East Ann Arbor Health and Geriatrics Center
UM Consulting Physician
Geriatrics Faculty
Revised on:
09/06/2012
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