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Patient Forms

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Referral Forms


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The Vascular Institute of Virginia has world-class physicians with a state-of-the-art facilities in Woodbridge, Fairfax and Fredericksburg, VA. We serve patients from our local communities as well as patients that travel from the entire country and from overseas. We provide treatments for many conditions including Men’s and Women’s Health, Vascular Disease, Kidney Failure, and Oncology. We provide a relaxed outpatient environment with modern comforts to make your experience comfortable and enjoyable.

Our unique practice has multi-specialty Vascular & Interventional experts. This allows us the advantage to see and treat an array of health issues and provide more comprehensive care within our multi-specialty team. Our team goes beyond health experts and covers the whole process of managing your treatment/health in order to provide excellent care.








Patient Forms

We are dedicated to providing you the best health care experience possible. For added convenience and to save you time at your next appointment, we ask that you please download and complete our patient forms shown below and bring them with you to the appointment.

If you are a Man being seen for prostate disease please fill out the form below.

If you are a Woman being seen for venous, arterial disease for your legs or any other gynecological issues please fill out the form below

If you are being seen for any other reason in our office, please fill out the forms below.

If you need to stay overnight please see information below on nearby hotels and airports.

Referral Forms


Everyone here is wonderful and they all have been so good to my mother,and now she feels like a new woman…..Thank you


The doctor’s office is never a pleasant place to visit because you normally are not feeling well. However, Dr. Washer and his team are the best; my experience has always been pleasant and prompt.


73 year old male. Research showed PAE procedure most likely to get best results, One year later, totally satisfied. Great results. Great patient care from the start and great follow up.


I couldn’t be happier with the service and personal attention I received there and would highly recommend them to my friends and family.


Excellent care. Dr. Washer is outstanding!


I had Pelvic Congestion for 10 years before anyone had even diagnosed it. I was in pain frequently, then I got referred to Dr. Piechowiak. She is awesome! She performed a procedure called Ovarian Vein Embolization and once I had that procedure I was totally pain free. Thanks Dr. P for changing my life

Rachel Spencer

Very helpful and clean location, excellent courtesy from everybody, excellent service and great help.


Get in Touch with Us

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Our Offices

1440 Central Park Blvd Suite 108
Fredericksburg, VA 22401

14085 Crown Court
Woodbridge, VA 22193

13135 Lee Jackson Memorial Hwy Suite 145
Fairfax, VA 22033



For Human Resources inquiries or Employment Verifications, please email

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