Suite 1/183 Tynte Street
North Adelaide SA 5006

Clinic Hours:
Mon – Fri 8:30 am – 5:00 pm

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GP Referral Form

Adelaide Vascular is located a short distance from Adelaide’s central business district.

There is good parking nearby and easy access, including disabled access, to our rooms.

Request An Appointment

Referrer Details

First Name

Last Name

Phone

Provider number

Address

Preferred Specialist

Preferred GP Selection

Patient Information

First Name

Last Name

Phone

Address

Date of Birth

DVA

Medicare number

Clinical details

Examination Request

Aorta - Iliacs

Carotids

Lower Limb Arteries

Lower Limb Arteries Left Right

Upper Limb Arteries

Upper Limb Arteries Left Right

Graft Surveillance

Graft Surveillance Left Right

Resting Doppler

Exercise Doppler

Toe Pressure

Renal Arteries

Ovarian Veins

Varicose Veins / Incompetence

Varicose Veins / Incompetence Right Left

DVT

DVT Right Left

Vein Mapping for Bypass Graft (lower limb)

Vein Mapping for Bypass Graft (lower limb) Lower Limb Right Left

Vein Mapping for Bypass Graft (upper limb)

Vein Mapping for Bypass Graft (upper limb) Lower Limb Right Left

Vein Marking for Varicose Vein Surgery (lower limb)

Vein Marking for Varicose Vein Surgery (lower limb) Right Left

Vein Marking for Varicose Vein Surgery (upper limb)

Vein Marking for Varicose Vein Surgery (upper limb) Right Left

Refer your patient to one of our four vascular surgeons

Surgeon Contact Details

Contact Information

Suite 1/183 Tynte Street North Adelaide SA 5006
(08) 8267 3511
(08) 8239 0644
info@adelaidevascular.com

Linkedin-in

Clinic Hours

Mon – Fri 8:30 am – 5:00 pm

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About
Doctor Information
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Services
Contact

Home
About
Doctor Information
Patient Information
Services
Contact