Referring a patient

When to consider referral

• A foot or ankle wound that hasn’t healed after 2–4 weeks of appropriate care
• Diabetic foot ulcer, including a recurrent ulcer over a bony prominence or a toe deformity
• Suspected osteomyelitis (a positive probe-to-bone test or X-ray changes) or a deep foot infection
• Diabetic foot infection, especially moderate or severe infection that may need drainage or debridement
• Acute Charcot neuro-osteoarthropathy (a warm, swollen foot with neuropathy), or a Charcot deformity with an ulcer
• Peripheral artery disease with a foot wound: we coordinate vascular assessment and revascularization with a vascular specialist
• Dry or wet gangrene of a toe or of the foot
• A failed or broken-down amputation site, or a transfer ulcer after a partial foot amputation
• Venous leg ulcer that isn’t healing with compression and local care
• Surgical wound dehiscence, or a surgical wound that won’t close
• Second opinion before a recommended amputation

What to send

Please fax the referral sheet along with:

• Patient demographics and contact information
• Insurance information (front and back of card) and any required referral or authorization
• Recent clinical notes and your question for us
• Wound history: how long it has been open, treatments tried, and recent measurements
• Hemoglobin A1c, kidney function and recent inflammatory markers, where available
• Vascular studies (ABI, toe pressures, arterial duplex) and any vascular procedure reports
• Culture results and current or recent antibiotics
• X-ray, MRI or CT reports and, where possible, the images (X-ray and ultrasound are available on site, so a referral doesn’t need to wait for new films)
• Prior operative reports

What happens next

Our office contacts your patient to schedule. After the evaluation, a consultation note with our findings and plan is sent to your office, and we keep you informed as the wound heals or if surgery is recommended.

For urgent problems, such as a wound with spreading infection, an abscess, wet gangrene, or a new, warm, swollen foot in a patient with neuropathy, please call and ask to speak with the clinical team, so your patient can be seen quickly. A patient who is systemically unwell, or who may have a necrotizing infection or an acutely ischemic foot, should go to the emergency department first.