A referral for an evaluation by the UF Health Craniofacial Center team can be made by a physician or health professional who is concerned that a child or adult may need medical, surgical, dental, psychological, speech, or hearing interventions for any craniofacial malformation. If you or your patient’s insurance requires a referral from the PCP, please have the PCP fill out and send the request to expedite the process.
To make a referral, please review the medical records needed listed below, and then fill out a Referral Form and FAX or mail it to:
Holly Shenk, RN, CPN, CLC
Craniofacial Center Clinic Coordinator
Phone: (352) 627-9326
Toll-free: (800) 726-2029
Fax: (352) 627-4564
UF Health Craniofacial Clinic
Division of General Pediatrics
Department of Pediatrics
1699 SW 16th Avenue
Gainesville, FL 32608
Medical Records Needed
Newborns
- Newborn discharge note & paperwork including Birth weight and length, information about pregnancy & delivery, any diagnostic testing that had been done, and results of newborn hearing screen
Infants
- Newborn discharge note & paperwork including Birth weight and length, information about pregnancy & delivery, any diagnostic testing that had been done, and results of newborn hearing screen
- Name of Pediatrician, results of newborn screening & other diagnostic testing, weekly weight growth chart, feeding information
Toddlers
- Newborn discharge note and paperwork including birth weight and length, information about pregnancy & delivery, any diagnostic testing that had been done, and results of newborn hearing screen
- Name of Pediatrician, results of newborn screening & other diagnostic testing, results of early intervention screening, speech screenings or interventional therapy evaluations or notes, information on previous surgeries.
Pre-School
- summaries of the early history is helpful
- a general physical from the referring physician
- testing and test results for concerns (this also includes genetic testing and imaging)
- summary reports are helpful: like a review of the status from another team, Psychoeducational assessments and academic records, operative and discharge notes, evaluation by a speech pathologist, dental x-rays, orthodontists, or oral maxillofacial surgeons notes. etc.
School Age
- summaries of the early history is helpful
- a general physical from the referring physician
- testing and test results for concerns (this also includes genetic testing and imaging)
- summary reports are helpful: like a review of the status from another team, Psychoeducational assessments and academic records, operative and discharge notes, evaluation by a speech pathologist, dental x-rays, orthodontists, or oral maxillofacial surgeons notes. etc.
Adolescents
- summaries of the early history is helpful
- a general physical from the referring physician
- testing and test results for concerns (this also includes genetic testing and imaging)
- summary reports are helpful: like a review of the status from another team, Psychoeducational assessments and academic records, operative and discharge notes, evaluation by a speech pathologists, dental x-rays, orthodontists, or oral maxillofacial surgeons notes. etc.
Young Adults
- summaries of the early history is helpful
- a general physical from the referring physician
- testing and test results for concerns (this also includes genetic testing and imaging)
- summary reports are helpful: like a review of the status from another team, Psychoeducational status or academic testing/ records, operative and discharge notes, evaluation by a speech pathologists, dental x-rays, orthodontists, or oral maxillofacial surgeons notes. etc.