| CONSULT REQUEST GUIDELINES
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Prosthesis for Upper or Lower Limb Loss
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| Suggested Pre-Referral Evaluation and Management Guidelines |
If phantom pain is a problem, consider initiating treatment with gabapentin, low dose tricyclic antidepressant or pregabalin
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| Suggested Additional Test/Management Prior to Specialty Visit |
If patient has previously worn a prosthesis, please have patient bring prosthesis to clinic.
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| Patient Education/Information (includes preps) |
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| Appointment Timeframe |
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| How to Get Results to Consultant |
UMHS Patients: See CareWeb
External Patients: hand carry medical records and clinic notes to visit |
| Clinic Contact Information |
Physician: 800-962-3555
Patient: 734-936-7175 |
| Clinic Location Sites |
Eisenhower Park West |
| UM Consulting Physician |
Amputation Management Faculty
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| Revised on: |
10/07/2009 |
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