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International Society for the
Study of Vascular Anomalies

ISSVA Multidisciplinary Team Submission Form

Directions:
Please complete this form for your Vascular Anomalies Team; please communicate with other team members prior to submission to guarantee there is only one submission from each team. Once submitted and approved, your team’s name, location, contact details, number of specialists and patient base (adults, children or both) will be posted online for members and the public to view.

Please note that we do not share personal information and we request that the person submitting this form is responsible for obtaining each team member's permission to list them on the below form and opt them into communication. It is also important to note that we will contact each team member you list below to inform them that they have been listed as a member of your team. For additional information, please review our Privacy Notice

Criteria:
We recognize that there is no fixed definition of what constitutes a multidisciplinary team and therefore we will provide some flexibility in deciding which teams meet the below criteria, which are based on the guiding principle that patients and referring practitioners do not necessarily know which specialty is the most appropriate for them. Therefore, we believe a multidisciplinary team is a location where patients can be referred to a single contact point (coordinator), knowing that the team will allocate their care to the specialist most appropriate to their specific problem. As such, we do not believe that a site such as a private practice where a single practitioner sees all referrals, and refers on to other specialties as required, constitutes a multidisciplinary team. We have provisionally defined a multidisciplinary team as one which:

  • Holds scheduled meetings at which patients are discussed and treatment decisions made at least once a month.
  • At least three of the following four specialty groups should regularly participate in these meetings:
    • Dermatology
    • Interventional Radiology
    • Surgery (Plastics, ENT, General Surgery, etc.)
    • Other Physician (Pediatrics, Oncology, Genetics, etc.)

 

Coordinator / Primary Contact:


Institution Details:





Patients:

Multidisciplinary Team Members:
Team Member #: 1
Team Member #: 2
Team Member #: 3
Team Member #: 4
Team Member #: 5
Add another team member  Add Another Team Member

If you have more than 15 team members, please contact ISSVA at info@issva.org to add these individuals to your team list.

Additional Team Information:

Thank you for your interest in being listed online as a Vascular Anomalies Multidisciplinary Team.




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