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Information for Referring Physicians

Protocol for Referring Mohs Surgeries

Mohs Contact Information
Mohs Scheduling Line: (801) 581-4756
Fax: (801) 581-2895

For an easy referral form (Excel file) go to:
Surgery Referral Form

The University of Utah, Department of Dermatology, and Huntsman Cancer Institute, greatly appreciates your referrals and will gladly assist you in providing the highest level of care for your patients who require Mohs Micrographic Surgery.  We have set up the following guidelines to insure your patients are scheduled and treated in a timely manner.

The following is a list of our Mohs surgeons and their locations.  This varies depending on the day of the week. 

Glen M. Bowen, M.D.
Huntsman Cancer Institute

Michael L. Hadley, M.D.
University of Utah Hospital, Clinic 28, Mohs Surgery and Medical Dermatology Clinic
University of Utah Dermatology South Clinic

Bradley K. Summers, M.D.
Huntsman Cancer Institute 
University of Utah Dermatology South Clinic

Payam Tristani-Firouzi, M.D.
University of Utah Dermatology South Clinic
University of Utah Hospital, Clinic 28, Mohs Surgery and Medical Dermatology Clinic

 
The Referral Process

Please inform your patient of the following:

  1. Please ensure that your patient is aware of their biopsy results and that they are being referred for Mohs Micrographic Surgery for treatment of their skin cancer. 
  2. Every effort will be made to schedule the patient for surgery at the earliest convenience. However, due to the high volume of referrals, it may take up to four weeks for the surgery to be performed. Please let your patient know how long the diagnosis can safely wait before being treated.
  3. A consult with us is not necessary, nor is it required prior to surgery.  If the patient wishes to meet with one of the Mohs surgeons first, this can be arranged.  However, there may be a longer wait for a consult than for the procedure, depending on the provider's schedule.  Please kindly inform your patients about this issue.


You may click on Surgery Referral Form (Excel file) to access a referral form OR you may fax the following to (801) 581-2895: 

  • Pathology Report - we cannot schedule a Mohs procedure without this.
  • Patient name, DOB, SS#, Address and Phone Number
  • Insurance Information
  • Specify the preferred surgeon. If you have no preference, please write "first available" on the paperwork.
  • Be specific about which site(s) needs Mohs and the diagnosis for each site.
  • Any notes or messages relevant to the treatment.

 *Note-Due to the high volume of referrals, please allow us 3 to 5 business days to contact the patient before inquiring about their status.