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Schedule a Holmium:YAG Surgical Laser Procedure

Pricing includes delivery, setup, ANSI laser safety signs, ANSI laser safety eye wear, a certified laser operator, any necessary smoke evacuation systems and any and all arthroscopy, urology, plastic surgery, dermatalogic, ENT, Ob/GYN, general surgery, and/or gastroenterology delivery systems.  Spinal probes vary depending on the facility's equipment and surgeon's preference and are furnished based on surgeon’s preference.   Pricing varies with spinal probe requested.
  • In order to schedule a procedure, complete one of the following for each case:

       ·  Submit a completed Service Request Form.

       ·  Print a Service Request Form to submit by fax.

      ·   Call our MST offices at (800) 765-9661 or (972) 735-8003.

      ·   Page your account representative.

  • MST schedules by the case. When the equipment is booked, please know the number of cases and type of procedure(s) for each case scheduled. This will enable us to ensure the right number and type of probes are delivered with the equipment.
  • When the equipment is scheduled, please have the surgeon(s) name(s), phone number(s) and an office contact person.
  • The equipment will be delivered and set up by our certified laser operators.
  • The laser operator will operate the laser and make setting adjustments during the procedure, as directed by the surgeon(s).
  • A rental delivery form will be given to you immediately following the scheduled surgery.  A purchase order is due as soon as services are rendered.
  • If there is a cancellation without within 48 hours of the scheduled delivery, a cancellation fee will be invoiced.

 

Ho:YAG Laser System: Service Request Form

 

System:

Today's Date:

Facility Name:

Surgeon's Name:

Requested Date of Procedure:

Time of Procedure:

Length of Time Requested for Procedure:

Type of Procedure:

Patient's Name:


Requested By:

Phone:

Fax:

Email:

Comments:

Scheduling Requests Will Be Confirmed by E-mail

 

 

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