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 Consultation Request form should be completed. The completed form can be either e-mailed or faxed to (937) 276-4419, to Wright State Vascular Surgeons.

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

Hospital Consultations:

Requests for hospital consultations during normal office hours should be made by calling our office at (937) 276-2642. After normal office hours please call our office and our answering service will notify the physicians.

Academic Department | Residency Program
Wright State University Boonshoft School of Medicine