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Vancouver Upper Limb Centre Vancouver Upper Limb Centre Vancouver Upper Limb Centre
"We are dedicated to improving access to care throughout the province for patients with upper extremity conditions."

Forms

Due to the busy nature of your surgeon's practice it is difficult to complete forms in a timely fashion. It is recommended that patients use their family doctor to complete forms. The expected course of recovery including: rehabilitation requirements and time off of work are usually dictated by your surgeon in the follow up letter to the Family Doctor.

If it is absolutely necessary to have your surgeon complete a form please allow ample time for completion. The completion of the  form is greatly facilitated by filling out the patient sections in their entirety. Any dates of clinic visits or surgery should also be entered.

» Request for Medical Records
Request for medical records should be printed out and sent to your other surgeon or doctor.

» New Patient History Form
The medical history form should be printed out, filled in and brought to the clinic.

General Post Operative Instructions:

A sheet will be provided to you before discharge. Do not lose this sheet. The sheet contains postoperative instructions specific to your surgery.

The sheet will describe the surgery that you received. It will describe wound care instructions, follow up instructions and other instructions such as physiotherapy referrals if required.

A copy of the sheet is provided:
» Post Operative Instruction Form - Dr. Thomas Goetz


New Referral Forms:

» General Referral Form
» Shoulder Referral Form
Please open the pdf in Adobe Acrobat and not in your web browser. This is a form that can be filled out online but only if it is opened in the Adobe Acrobat program or equivalent.