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Physician Referrals

Schedule a Complimentary Consultation

Refer a patient

to Wilmington plastic surgery

As plastic surgeons, our practice’s role is to collaborate, problem-solve, and support various medical specialists to ensure the best possible care for our patient’s health. Our clinic interacts with multidisciplinary approaches to internal medicine, oncology, orthopedic, and many other medical specialities.

We value the relationships between referring physicians and their patients, so we pride ourselves on delivering high-quality care and trained medical professionals with years of surgical experience in Southeastern North Carolina. Referring providers should rest assured they their patients will be in capable hands.

Referral and New Patient Consultation Requests

Patient Name(Required)
Date of Birth
Address(Required)
Max. file size: 50 MB.
Max. file size: 50 MB.
Provider Name(Required)

All of the following MUST be sent with the referral for our providers to review before a decision can be made.

  • Complete Patient Demographics:
    • Address
    • Working phone number
    • Copy of ALL insurance cards front and back
  • All Lab & Culture Results
  • Imaging Reports
  • All office notes pertaining to diagnosis
  • Medication List, Rx & OTC

A chart cannot be created and insurance verified without all of the requested information. An appointment will NOT be scheduled until all information has been received. Once the patient is scheduled, or if the request is denied, our office will fax you an appointment notification/declined explanation.

Max. file size: 50 MB.