Vascular/Interventional Radiology Services Forms

To schedule an appointment, please call Centralized Scheduling at 574-647-7700. Fax orders to 574-647-2200.

Services included in this order form are:

  • Ablation
  • Abscess Drain
  • Alcohol injection of Liver
  • Angioplasty/Stent
  • Aortogram with runoff
  • Arteriogram
  • Arthrogram
  • Aspiration
  • Biliary Catheter
  • Biopsy
  • Bone Marrow Biopsy
  • Chest Tube Placement
  • Chest Tube Pleurodesis
  • Declotting of Fistula
  • Discectomy/Disc Aspiration
  • Discogram
  • Dye Study of Port
  • Embolization
  • Facet Injection
  • Fistulogram
  • Gallbladder Drain
  • IVC Filter/Inferior Vena Cavagram
  • Lumbar Puncture
  • Opening Pressures
  • Methotrexate Injection (Intrathecal)
  • Myelogram
  • Needle Lung Localization
  • Nephrostomy Catheter
  • Neural Foraminal Injection/
    Nerve Root Block
  • Paracentesis
  • Perm Cath/Dialysis Catheter
  • PICC/Peripherally Inserted Catheter
  • Retrieval of Foreign Body
  • Sialogram
  • Transhepatic Cholangiogram
  • Thrombolysis Infusion (TPA)
  • T.I.P.S./Transhepatic Intrahepatic Portosystemic Shunt
  • Thoracentesis
  • Vascular CTA's
  • Vascular Ultrasound
  • Vertebroplasty
  • Venogram
  • Uterine Fibroid Embolization