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NEW PATIENTS

 

 

         New patients are required to arrive 30minutes prior to your appointment with your paperwork completed.  Failure to do so may result in rescheduling your appointment.

 

         Please call at least 24 hours in advance to reschedule your appointment.

 

         If you are more than 15 minutes late for your appointment, you will have the option to wait for the next available work-in visit (the wait time will vary depending on the day’s schedule). If you do not wish to wait for the next available work-in visit, we will be happy to reschedule your appointment.



Adult Patient Paperwork/Registration

Pregnancy Paperwork/Registration


Pediatric paperwork Birth to 2 Years

Pediatric paperwork THREE to FIVE YEARS
Pediatric paperwork SIX to EIGHTEEN years
                                                                                


Release of Medical Records Authorization


Sclerotherapy Paperwork

Please print, fill out, and bring with you to your sclerotherapy appointment the

 2 following forms:

Patient Questionnaire for Sclerotherapy

SCLEROTHERAPY INFORMED CONSENT




The following forms are informational handouts only.

Handout PRE TREATMENT

Handout POST TREATMENT