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 84 Marginal Way, Suite 985, Portland, ME 04101 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) or Renee Daigle (Medical Assistant) at 207.347.2660

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
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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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