Referral form

Please complete all of the areas on the form and email to leedsth-tr.erbspalsyleeds@nhs.net

Obstetric Brachial Plexus Referral Form

Address:

Named consultant

Obstetric Brachial Plexus Palsy Unit, Plastic and Reconstructive Surgery Department,

Clarendon Wing, Leeds General Infirmary,

Great George Street, Leeds LS1 3EX.