Appointments Use the convenience of our website to request an appointment and save yourself a few extra "steps"! Our office will contact you upon receiving your completed form. Tell us about yourself: * Required Information First Name * Last Name * Daytime Phone Number * Email Address * Please indicate how you would like to be contacted: Phone Email Have you been seen by Dr. L. Philipp Wall, M.D. before? Yes No Name of Insurance: Physician Referred By: Primary Care Physician Name: Preferred Day of Week (Select top two preferred days): Monday    Tuesday    Wednesday    Thursday    Friday    * Please list the nature of your problem, question or comment:     Copyright Arizona Vein and Vascular Center 2009. All rights reserved. Powered by AZYokel.com Home  |  Dr. L. Philipp Wall  |  Our Office  |  Our Services  |  Patient Forms Insurance  |  Appointments  |  Common Vein or Artery Problems  |  Site Map