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If you have a general nerve injury/condition and you would like to request an appointment with our surgeons in the Center for Nerve Injury and Paralysis, the following medical records/forms need to be faxed to our office at (314) 367-0225:

  • A letter of referral from your physician detailing the nature of your nerve condition or injury, including your symptoms and functional use of the affected extremity (-ities).
  • Reports of any diagnostic studies including EMG/nerve conduction studies, MRI, CT scans, ultrasounds.
  • Operative notes from previous surgeries to the affected extremity (-ities).
  • Demographics (address, phone number, date of birth, etc.) and health insurance information
  • Completion of the New Patient Forms including the General Health Questionnaire for Patients with a Nerve Injury/Condition, Pain Questionnaire, and SF-8 Health Survey. You can download these New Patient Forms by clicking this weblink.
  • If you are inquiring about making an appointment to be evaluated for nerve transfer surgery to restore hand function for a C6/C7 injury, please click this weblink for the New Patient Forms.

Alternatively, materials may be mailed to:

Washington University School of Medicine
Division of Plastics & Reconstructive Surgery
ATTN: Nurse Coordinator
660 S. Euclid Ave.
Campus Box 8238
St. Louis, MO 63110

Once all of the required records are received, they will be reviewed and you or your referring physician will be contacted.

For more information about our specialists, see Our Physicians web page.