Vascular Surgery: Physician Referral Information

Office Consultations

In most situations, patients are seen upon referral from their primary care physician. For those primary care physicians requesting a consultation, a Consultant Request form should be completed. The completed form can be faxed to the attention of Wright State Vascular Surgeions at (937) 208-6154.

Once a consultation form is completed and has been returned, an appointment is scheduled and the Consultant Request form is faxed back to the referring physician. Our office will notify the patient of the appointment date and time. The patient will also receive a confirmation letter, which includes date and time and directions to our office.

To assist us in providing optimal service, please forward all pertinent lab result and diagnostic tests to our office prior the date of the appointment.

On the day of the office appointment, patients are asked to bring the following:

• Completed Patient Registration form
• Completed Medical History form
• Current Insurance Information
• Complete medication list including all herbal supplements
• Copies of any tests or x-rays
• HIPAA Disclaimer

Hospital Consultations

Requests for hospital consultations during normal office hours should be made by calling our office at (937) 208-2552. After normal office hours please call our office and our answering service will notify the physicians.