Referral Protocols

Questions and Issues For You to Consider When Referring Your Patients
It is essential that patients bring all pertinent plain radiographs and arteriograms. Radiologist’s interpretation of x-rays are helpful but not sufficient.

Medical/Surgical Information
Most Important
1.     Name of Referring MD/Provider / Phone / Fax
2.     Reason for Referral and Expectations
3.     Problem List
4.     Medical / Surgical History
5.     Medication / Allergy List
6.     Recent EKG; Most Recent Angiogram and Ultrasound

Please send the following information if pertinent to the referral.
1.     Most Recent Office Note
2.     Previous Course of Treatment
3.     Operative Reports
4.     Most Recent Lab Tests

Patient Demographic Information
Name, Date of Birth, Address, Phone Number, Insurance Plan, Worker’s Compensation Information, if applicable

VASCULAR DIAGNOSTIC LABORATORY

Recent advances in vascular diagnosis permit accurate, non-invasive assessment for diseases of the peripheral vascular system.  The Clinical Vascular Laboratory offers state-of-the-art, non-invasive testing to accompany standard clinical evaluation.  Use of non-invasive techniques can improve the accuracy of diagnosis, document the degree of progression of the disease, and avoid unnecessary testing.  The non-invasive vascular laboratory combines with existing services in vascular surgery to provide total care for patients with arterial and venous diseases.

TO SCHEDULE AN APPOINTMENT

Telephone:
802-847-8827

Fax:       
802-847-0970

Location:   
Level 5, Main Pavilion       
Medical Center Campus
111 Colchester Avenue,    
Burlington, VT 05401

Office Hours:   
Monday-Friday, 8:00 am-5:00 pm

Referral Information
This is information the Vascular Laboratory Specialist needs to provide the best care for your patient.

Questions and Issues For You to Consider When Referring Your Patients
1.     Please complete a vascular laboratory referral form.

Medical/Surgical Information
Most Important
1.     Name of Referring MD/Provider/Phone/Fax
2.     Reason for Referral and Expectations

Please send the following information if possible. It is desirable, not essential.
1.     Problem List
2.     Operative Reports
3.     Procedure Reports
4.     Hard Copy Images

Patient Demographic Information
Name, Date of Birth, Address, Phone Number, Insurance Plan,Worker’s Compensation Information, if applicable