Canadian/Self-Pay

Buffalo Vascular Care welcomes Canadian patients for evaluation and treatment of:

  • Uterine fibroids with uterine fibroid embolization (UAE/UFE)
  • Pelvic congestion syndrome with ovarian vein embolization
  • Varicose veins with venous closure using Venaseal or radiofrequency ablation and sclerotherapy
  • Vertebral spine fracture with kyphoplasty
  • Peripheral arterial disease (P.A.D.) arterial blockage in lower extremities with advanced endovascular nonsurgical techniques

 

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Patient Forms

Click to download each of the forms below to fill out before your appointment.

 

Surescripts Consent Form

Surescripts is an electronic database used to access your medication history. Knowing and understanding your medications is what makes us able to give you the best treatment, the treatment you deserve.

View Our Surescripts Consent Form Here

HEALTHeLINK Consent Form

This consent form gives us authorization to access health information regarding my care and treatment through HEALTHeLINK.

View The HEALTHeLINK Consent Form Here

HIPAA Consent

HIPAA protects the confidentiality and security of a patients health care information therefore, it is required that we get your written consent for certain information.

View The HIPAA Consent Form Here

Canadian/Self-pay Financial Policy

The link below will download a PDF list of guidelines that are necessary in order to continue to provide high quality care and make your visit as pleasant as possible.

View Form Here

Directions

Click the button below for Printable Directions to our facility.

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