Patient

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 confirm receipt of your information within a day. 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.

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Visualase Patient Form
  1. (required)
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  3. (valid email required)
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  9. 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.
  10. Mail a copy of the CD to: Visualase Inc. Attn: Patient Support, 8058 El Rio Street, Houston, TX 77054
  11. If you would like for us to help you obtain your MR images, please provide us with the facility that conduted your latest MRI.
  13. (required)
 

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