CONSULT REQUEST GUIDELINES                                                                         Print

Sex Reassignment Surgery

Suggested Pre-Referral Evaluation and Management Guidelines
1) Past medical history pertinent to condition.
2) Complete surgical history
3) Past operative notes specific to condition.
4) Past medical history for co-morbidities.
5) Evidence of compliance with standards of care according to the World Professional Association for Transgender Health.
Ph. 734-763-0466
Fax No. 734-615-7772
Suggested Additional Test/Management Prior to Specialty Visit As per requirements of UMHS Comprehensive Gender Services Program (UMHS-CGSP)
Patient Education/Information (includes preps) Provided by Program.
Appointment Timeframe Next Available; Patients MUST be referred by UMHS Comprehensive Gender Services Program (UMHS-CGSP), no self or outside referrals can be scheduled without approval from Dr. Kuzon.
How to Get Results to Consultant UMHS Patients: See MiChart
External Patients: Send records to:
UMHS 300 North Ingalls Room NI4D-21
Ann Arbor, MI 48109-0475
Clinic Contact Information Physicians: 800-962-3555
Patient: 734-998-6022
Clinic Location Sites Dominos Farms
UM Consulting Physician David Lawrence Brown MD
Paul Stephen Cederna MD
Robert Harris Gilman MD
Steven Carl Haase MD
Jeffrey Hall Kozlow MD
William Michael Kuzon Jr MD
Adeyiza Olutoyin Momoh MD
Edwin Grant Wilkins MD
Revised on: 03/24/2014



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