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Physician Contact Form

Please use the form below to contact with question, comments or for a list of Physicians in your area.

Title:
First Name*:
Last Name*:
Address:
City:
State:
Zip:
Country:
Phone*:
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Medical Specialty:
Clinic/Hospital:
 
I am interested in the following:
Have a local representative contact me
Send product literature
Pricing
Practice Enhancement Support (MBA)
Other
 
Please complete the following:
 
I currently treat patients with varicose veins or venous insufficiency
Yes No
 
I currently use the following methods for treating these patients:
Ligation & Stripping
Radiofrequency Ablation
Endovenous Laser
Other
 
I see the following number of new venous reflux patients per month:
1-5
6-10
10-20
20 or more
 
I currently treat the following number of venous reflux patients per month:
1-5
6-10
10-20
20 or more
 
Comments/Questions

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Yes, I would like to receive updates on AngioDynamics Inc. Events
 

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AngioDynamics Customer Service

Tel: +1-800-772-6446
Fax: +1-518-798-1360
e-mail: customerservice@angiodynamics.com
Web: www.AngioDynamics.com

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