| CONSULT REQUEST GUIDELINES
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Hematology
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| Suggested Pre-Referral Evaluation and Management Guidelines |
Refer directly to Adult Hematology Clinic. Referral should be made after diagnosis is lab proven by more then one episode
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| Suggested Additional Test/Management Prior to Specialty Visit |
Copy of labs, radiology/pathology reports; physician notes or legible summary letter pertaining to diagnosis; chemo records when applicable; these must be received BEFORE an appointment can be made. Pathology slides and/or radiology films may be brought by the patient or Fed-Ex'd to us by appointment time.
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| Patient Education/Information (includes preps) |
For patient information including pre-appointment forms, maps & directions, participating insurance plans, and support:
http://www.cancer.med.umich.edu/patients/index.shtml
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| Appointment Timeframe |
Varies between diagnosis & provider
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| How to Get Results to Consultant |
UMHS patients: See CareWeb
External Patient: Fax to: 734-647-8664
UPS/Fed Ex films and slides to:
UM Cancer Center
B1-358 Reception B
1500 E. Medical Center Drive
Ann Arbor, MI 48109 |
| Clinic Contact Information |
Physicians: 800-962-3555
Patient: 734-647-8901 |
| Clinic Location Sites |
Comprehensive Cancer Center
Canton Health Center |
| UM Consulting Physician |
Asra Z. Ahmed, M.D.
Paula L. Bockenstedt, M.D.
Harry P. Erba, M.D., Ph.D.
Scott D. Gitlin, M.D.
Mark S. Kaminski, M.D.
Lisa A. Kujawski, M.D.
Sami N. Malek, M.D.
Samuel M. Silver, M.D., Ph.D.
Moshe Talpaz, M.D.
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| Revised on: |
06/15/2010 |
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