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New Patient Supporting Documents for Adolescent Gynecology


Diagnosis/Symptom: Any

What should the referring provider send?

  1. The relevant visit note/medical records related to the concern or reason for referral.
  2. A list of all current medications.
  3. The names of any medications previously prescribed to address the diagnosis/symptom.
  4. If done, the results of any relevant labs (for example, TSH, Prolactin, any hormone levels, CBC).
  5. If done, the result of any relevant cultures (for example, vaginal or urine culture).
  6. If done, the report from any relevant imaging (most common: Pelvic ultrasound).