Clinical Telehealth Program Rheumatology Adult Telehealth Consultations Appointment Scheduling New: 60 minutes We offer telehealth consultations for a variety of adult rheumatology conditions. If you would like to refer a patient for a condition that is Follow-up: 30 minutes not listed, please send your request along with the patient’s chart Level of Presenter notes to the telehealth coordinator for the specialist’s consideration. Required at Consultation Clinical Conditions* M.D., N.P., P. A . • Ankylosing Spondylitis • Antiphospholipid Syndrome New: Option to introduce, • Calcium Pyrophosphate Deposition (CPPD) requires 10 minutes at • Carpal Tunnel Syndrome • Dermatomyositis and Polymyositis end of visit and available for exam if needed • Giant Cell Arteritis • Gout • Granulomatosis with Polyangitis (Wegener’s) Follow-up: Requires five minutes at end of the visit • Inflammatory Myopathies • Lupus • Lyme Disease • Osteoarthritis Required Equipment • Osteonecrosis of Hip • Paget’s Disease of Bone • Videoconferencing Unit • Polymyalgia Rheumatica • Psoriatic Arthritis • Raynaud’s Phenomenon • Reactive Arthritis • Rheumatoid Arthritis • Scleroderma Consultants • Sjogren’s Syndrome • Spondyloarthritis Nancy E. Lane, M.D. • Takayasu’s Arteritis • Tendonitis and Bursitis Barton L. Wise, M.D., • Vasculitis MSc, FACP *Please check with the Clinical Telehealth Program for any conditions not listed to see if it is appropriate for telehealth. Information Needed Prior to Scheduling an Appointment • Telehealth Referral Request Form UC Davis Health Clinical Telehealth Program • Pertinent patient records, labs and imaging studies Toll Free Phone: Information Needed Before the Consultation Begins (877) 430-5332 • Signed UC Davis Health Acknowledgement of Receipt: Notice of Referral Fax: Privacy Practices form (new patients only) (866) 622-5944 • Documented verbal consent from the patient for participation in a [email protected] telehealth consultation health.ucdavis.edu/cht.