New Patient Forms

NEW PATIENT FORM

Are you a new patient? Save time by filling out our New Patient Form before you come in. The form asks you to fill out your basic personal information as well as your insurance info, medical history, medications you are currently taking, and if you have any allergies.

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NOTICE OF PRIVACY PRACTICES

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

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NON-DISCRIMINATION POLICY

The Vein Company's Statement of Non-Discrimination.

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MEDICARE SURVEY

This file is for patients with Medicare services.

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GOOD FAITH ESTIMATE NOTICE

Under the law, health care providers need to give patients who do not have insurance or who are not using insurance an estimate of the expected charges for medical services.

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