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Consult Request Guidelines
for Prosthesis for Upper or Lower Limb Loss
Prosthesis for Upper or Lower Limb Loss
Suggested Pre-Referral Evaluation and Management Guidelines
If phantom pain is a problem, consider initiating treatment with gabapentin, low dose tricyclic antidepressant or pregabalin
Suggested Additional Test/Management Prior to Specialty Visit
If patient has previously worn a prosthesis, please have patient bring prosthesis to clinic.
Patient Education/Information (includes preps)
Appointment Timeframe
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
Revised on:
10/07/2009