New Patient Supporting Documents for the Burn Program


Diagnosis/Symptom: Burn Injury

What should the referring provider send?

  1. A list of medications used to treat the burn wound.  
  2. What dressing has been used to treat the burn wound.
  3. Medical records regarding relevant past evaluation and treatment of the burn.
  4. Relevant laboratory reports.

Diagnosis/Symptom: Friction Injury ie: Treadmill injury, Road rash

What should the referring provider send?

  1. A list of medications used to treat the wound.
  2. What dressing has been used to treat the wound. 
  3. Medical records regarding relevant past evaluation and treatment of the wound.
  4. Relevant laboratory reports.

Diagnosis/Symptom: Frostbite

What should the referring provider send?

  1. A list of medications used to treat the wound.
  2. What dressing has been used to treat the wound.   
  3. Medical records regarding relevant past evaluation and treatment of the wound.
  4. Relevant laboratory reports 

Diagnosis/Symptom: IV infiltration

What should the referring provider send?

  1. A list of medications used to treat the wound.
  2. What dressing has been used to treat the wound. 
  3. Medical records regarding relevant past evaluation and treatment of the wound.
  4. Medication infusing in the IV at the time of infiltration.