Yale University - Interventional Radiology, radiology, fibroid, fibroids, embolization, uterine, varicose, varicocele, interventional, radiology - Online Forms
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Click here to visit Yale University Vascular Malformation Center a center without walls, dedicated to the care and management of patients with vascular malformations.

Learn more about some of the services we provide:
Fibroid Tumors of the Uterus
Uterine Fibroid Embolization
Varicose Veins
Varicocele Information

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Online Forms
This pre-visit form will help you consolidate your medical history in preparation for your visit to our office. Please either complete this form online and print it, or print it and fill it out by hand. Please bring this form with you when visiting our office.

Note: Completing this form online WILL NOT retain any record of your personal information. It is designed solely for your convenience, to help utilize your time with us most productively. You will need to print a second copy if you want to keep a record of this information.

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