Neurosurgery Laser Ablation Inquiries «

Neurosurgery Laser Ablation Inquiries

Many physicians are not yet aware of technologies such as Visualase. We can share your condition and history with physicians that have been trained to use Visualase.

We will contact you within 5 business days of receipt of your history and image studies to let you know whether you are a candidate for the Visualase procedure, and will then connect you to a physician quickly.

To submit MRI images or other zip files, follow this link.

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Neurosurgery Inquiry

Does patient have a cardio pacemaker or aneurysm clip?
Contact Name(required)
Contact Telephone(required)
Contact Email(valid email required)
Patient Name
Patient Age(required)
Patient Zip Code
Medical HistoryPlease describe current diagnosis and any prior treatments.(required)
Physician(s) Name(s)(Optional)
A physician will need to evaluate the latest MRI exam. You should be able to obtain a copy of this on CD from the facility that conducted the MRI.
Mail a copy of the CD to: Visualase Inc. Attn: Patient Support, 8058 El Rio Street, Houston, TX 77054
Information collected from this website or provided on any form to
Visualase Inc. is used only in conjunction with an expressed interest
by you in obtaining additional information about Visualase Laser
Technology. It does not create any type of relationship between the
individual providing the information and Visualase Inc. or any of the
physicians that review the information provided. Visualase Inc. will
not be liable for you and you will release and hold them harmless
from any claims and/or any direct, indirect, consequential, special,
exemplary, or other damages arising therefrom. This information
will be used to contact you because you have requested that you
be contacted. Visualase Inc. will release this information to selected
physicians and can not be held responsible in the small chance that
this information gets relased to other 3rd parties. You authorize
Visualase Inc. to release any Protected Health Information collected
from this website. "I authorize the use and/or disclosure of my PHI as
described above. I have read the contents of this Authorization, and I
fully understand and accept its terms." In order to confirm that you
have read and agree to the above, please select "Agree"(required)
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Neurosurgery Laser Ablation Inquiries

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