If you are a healthcare professional looking to refer a patient to us, please fill out the appropriate form below.

• Patient Referral Form - Online Fillable
• Referring Provider Video Brief
• Patient Referral Form -Download PDF
• Sample Ultrasound Report

CLICK HERE for a list of our vascular outpatient centers, vascular labs, and offices throughout Maryland, Washington DC, and south central Pennsylvania.

If you have any questions or concerns, please contact our office directly by phone or submit your question online, and one of our team members will be happy to assist you. Online inquiries receive a response within 24 – 48 hours.

A Referral Process that’s easy for you, your staff, and your patients…

1. Complete a prescription or referral form for a consult and/or ultrasound, and provide your signature.

2. Make a copy for your patient then fax the referral form to 1 of our 17 offices (Click here for locations and fax numbers).

3. Once we receive your referral, a patient care coordinator (PPC) will contact your patient. They will call three times in a 7 day period; failure to reach the patient will result in a follow-up call to your office.

4. Once an appointment is scheduled, our PCC will fill out the appointment date on the original referral form and fax it back to your office.

5. Post consult notes, ultrasound reports, and post-op reports will be faxed over within 48 hours of the appointment (STAT reports are 24 hours).