Consultations

Referrals

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:
(207) 956-6650

Patient Medical History and Billing Information

Patients are asked to complete the following forms prior to their first consult:

Patient Medical History Questionnaire

Venous Medical History Questionnaire (only for patients with venous insufficiency / varicose veins)

Patient Billing Information

To obtain additional information from our office, please complete the following form and someone will be in contact with you.

* First Name
* Last Name
* Address
* City
* State
* Zip
Day Phone
Night Phone
* Email Address
Questions and Comments
	Include me in your mailing list.

	*Required Fields

Technology Updated

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.
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