When making a referral to Vascular and Interventional Physicians, the following information is needed:
- Completed Vascular and Interventional Specialty Referral Form
- History and Physical
- Recent office notes
- Recent pertinent hospital records
- Recent labs
- Imaging - if the imaging is not within the PACS system. Imaging can be mailed to our office at 33 Sewall Street, Portland, ME 04102 (effective 6/28/13) or patient can hand carry the disc.
- Patient's insurance information including ID number, group number, provider or customer service phone number.
Questions can be directed to Deanna Peare (Patient Scheduling Coordinator) at 207.347.2660
New Phone Effective 6/28/13:
Patient Medical History and Billing Information
Patients are asked to complete the following forms prior to their first consult:
Venous Medical History Questionnaire (only for patients with venous insufficiency / varicose veins)
To obtain additional information from our office, please complete the following form and someone will be in contact with you.
Did You Know? We treat varicose veins and spider veins? Varicose veins are swollen veins which protrude in a rope-like manner under the skin. Normal veins, by virtue of one-way valves, channel blood against gravity up the leg and back to the heart. When a valve becomes defective, it allows blood flow to leak back down the leg resulting in congestion and swelling of the vein. This is a medical condition called Venous Insufficiency.