Dr Robert Hermann Podiatric Surgeon Referral for Podiatric Surgery To discuss a case call Dr Hermann on: 08 8341 5598 or email: [email protected] Date Practice Patient Name Referring Practioner Patient phone number I am referring this patient for a surgical opinion on: BunionsHammer toesHeel pain/fasciitisNeuromaSkin lesionNail pathologyWartsToe painMidfoot painCavus feetAnkle pain / instabilityFlat feet Other: Have current imaging examinations been performed? YESNO Call 04049100054 or email [email protected] for advice on appropriate imaging if required. Medical conditions Medications Allergies Clinical history Previous treatment Δ
