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Charles O. Strickler Transplant Center Liver Transplant Referral Form Fax to: Ashleigh JacksonFax #: 4349248774 (Please Print) Liver Only Liver and Kidney On DialysisTodays date: Consult Only Other
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This surgeon is redefining standard surgical techniques and practices in order to improve patient outcomes and safety.
Surgeons who perform specific procedures and those involved in surgical practices are required to file this information.
To fill out this form, you must provide your personal and professional information, details about the procedures involved, and any outcomes or changes in practice.
The purpose is to ensure updated practices are documented and to enhance the overall quality of surgical care.
Information such as surgeon credentials, procedure details, patient outcomes, and any innovations in technique must be reported.
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