In the boxes below, please tell us about your or your child’s care team at home.

As we are scheduling the first appointment, we need to go over your or your child’s medical records. This includes notes about appointments and tests. Please send a sample of medical records. For example, send the earliest, middle and most recent visits. You do not need to send the entire medical record. The Medical Genetics Coordinator will mail or email the hospital consent form to you. Then you will mail the consent form to the doctor or hospital. They will send us the medical records to prepare for your appointment, which must arrive before the visit.

Specialty Name of doctor or hospital Location (City) Type of record to send to the Myhre Syndrome Clinic
Primary Care Provider    
  • Most recent visit notes
  • Growth curves
Geneticist (genetics doctor)    
  • Consultation notes
  • Lab report for the SMAD4 test
Cardiologist (heart doctor)    
  • First and last visit notes
  • Catheterization notes
Pulmonologist (lung doctor)    
  • First and last consultation notes
  • Pulmonary function test results
ENT doctor (airway doctor)    
  • First and last consulatation notes
  • Most recent ear exam notes
Audiologist (hearing doctor)    
  • First and last visit notes
Eye doctor    
  • First and last visit notes
Endocrinologist (hormone doctor)    
  • First and last visit notes
Orthopaedic (bone) doctor    
  • First and last visit notes
  • Skeletal survey
Dermatologist (skin doctor)    
  • Consult note
Psychiatrist or psychologist (mental health doctors)    
  • Neuropsychological testing
  • Most recent visit notes
Rheumatologist (joint doctor)    
  • First and last visit notes
Other doctors      
Rev. 7/2017.