Consultation Request for IVC Filter Removal You must have JavaScript enabled to use this form. To request a consultation, please flll out the below form. We are happy to provide you the best quality care we can. Your Information Patient's Name * Patient's Date of Birth * Phone Number Patient's Primary Care Provider Reason filter was placed Prior failed attempt at retrieval? Yes No Is patient on anticoagulation (also known as blood thinners)? Yes No Best time to contact patient? Morning Afternoon Evening Has the patient been seen at Ï㽶ÊÓƵ of Utah Health or Huntsman Cancer Institute in the past? Yes No Call 801-581-2957 or Leave this field blank
