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Referral Info

Thank you for your continued support of MVSS

Please do not hesitate to call should you have any questions or concerns about your referral. Below are some preferences and a referral form for your use. Feel free to e-mail medical records, referral forms and diagnostic information to us.


  • Referrals are preferred, but not necessary for an initial examination and consultation.
  • Patient Blood work:
    • Healthy Patients: blood work should be less than 30 days old.
    • Geriatric Patients: blood work should be less than 14 days old.
    • Patients with multiple co-morbidities: blood work should be less than 7 days old.
    •  Blood work should include a CBC and a full chemistry.
    • Please advise your client that additional blood work may be required prior to surgery and during hospitalization.
  • Patient Radiographs
    • Oncology Patients: three views of the thoracic cavity.
    • Orthopedic Patients: two views of the affected region.
    • MVSS will repeat the radiographs at the time of surgery. These radiographs are necessary to measure and template prior to procedures.
    • Please advise your client that additional radiographs may be require to facilitate examination and diagnosis.
  • The complete patient record will be digitally faxed or emailed to your practice after your patient has been discharged.
  • Histopathology reports will be faxed to your practice once the report is available.

Please click the link below for a referral form.

Surgical Referral Form – Download and Print