Patient Resources: Patient Forms, FAQs, Links & More

New Patient Forms and Information

• New patient intake form (please bring the completed form to your first appointment)
• Insurance Plans
• Post Operative FAQ

Rectangle Health Payment Portal

PAY ANY HEALTHCARE BILL

Instruction Sheets

• Pre- & Post-operative instructions (home care, drain care & drain logs, nutritional information)

General Information Sheets

• Breast reconstruction with tissue flaps
• Breast reconstruction with latissimus dorsi muscle-skin flaps
• Breast reconstruction with tissue expanders and/or implants
• Nipple reconstruction and areola tattooing
• American Cancer Society’s General Information Pamphlet on Breast Reconstruction After Mastectomy

Useful Links

Laws, Acts, and Legislation

• Women’s Health and Cancer Rights Act of 1998 (WHCRA)
  This page from the United States Department of Labor is an excellent resource for learning more about the WHCRA of 1998, which federally mandates insurances to cover breast reconstruction for breast cancer patients.
• Lizzie B. Byrd Act (Ohio House Bill 147)
  Ohio requires a surgeon performing a mastectomy in a hospital to guide the patient and provide referrals in a manner consistent with the standards of the National Accreditation Program for Breast Centers. Read Dr. Tiwari’s testimony to Ohio Senate Medicaid, Health and Human Services Committee.

Organizations and Websites

• BreastRecon.com
  A website was organized by Kathy Steligo, who has had breast cancer twice, bilateral mastectomy and reconstruction with both expander/implants and GAP flaps.
  The site contains an active blog, lots of helpful content, and a list of surgeons who specialize in advanced breast reconstruction.
• Breastcancer.org
  This site features active discussion boards on topics covering almost every aspect of breast cancer diagnosis, treatment, and reconstruction.
• Diepcjourney.com
  A breast cancer patient writes about her treatment and reconstruction. Loaded with helpful first-hand accounts of her journey and the information she gathered along the way.
• PinkRibbonGirls.org
  An organization committed to providing breast cancer patients in many parts of Ohio with valuable services, such as meals, house cleaning, and rides to the appointment.
• DiepReconstruction.com
  An informative site about DIEP Flap breast reconstruction.
• Realself.com
  It is a place for consumer reviews, stories, and discussions about cosmetic treatments and procedures for the face, body, skin, and smile. Where you can find a doctor, you can trust.

*The information available on this page was created to educate our patients. It is not an alternative for a formal consultation with a board-certified plastic and reconstructive surgeon. Individual results vary per patient. For more information, we strongly recommend scheduling a consultation with our doctors.