Patient presents for SUTURE REMOVAL
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____ Day(s)
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___ Week(s) status post:
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Surgical Excision of
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Surgical Re-Excision of
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Incisional Biopsy of:
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Scar Revision of
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Other
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Patient presents for FOLLOW-UP
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__ day(s)
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__ week(s)
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__ month(s) status post:
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Horizontal Excision/Shave Biopsy of
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CO2 Laser Treatment of
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Surgical Excision of
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Surgical Re-Excision of
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Other
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Pathology benign/positive
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for ___
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Patient is scheduled to return in approximately
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Select service from list
• • •
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Lydia J. Anders, PA-C
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Mark S. Potenza, MD
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