Click here to open a pdf version of the Referral Slip.

Pacific Vascular is proud to have achieved the classification as an Independent Diagnostic Testing Facility (IDTF). The resulting change in classification with the Carriers for Medicare & Medicaid Servies (CMS) requires that we receive a written order for each patient which includes:

Clinical Indications
Test Ordered
Physician's Signature (or an appropriate agent of the physician)

Please be sure that a written order is provided to each patient to bring to their appointment. (Maps to help patients find our lab locations are printed on the back of each referral slip).

If you are in need of Pacific Vascular referral pads, please call (425) 398-7773)