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Patient Forms

We offer easy access to the most common patient forms used during your care at the Vein Healthcare Center. Our downloadable forms list provides a simple way to access patient information or access forms required prior to your appointment at the Vein Healthcare Center. Our staff at the Center will direct you to the forms appropriate for your visit.

Being fully prepared for your appointment and following guidelines for care before and after treatment will facilitate the best experience and promote the most effective healing so you can return to your daily routine as soon as possible.

New Patient Forms

Download All New Patient Forms

Please bring your completed new patient paperwork (Demographic Information, Medical Information, HIPAA Notice, and Appointment Reminder) with you to your first appointment, or email the completed paperwork to us at info@veinhealthcare.com, or fax it to us at 207-221-3544.

Pre-operative and Post-operative Patient Information

EVLA/RFA | (PDF Version)
Sclerotherapy | (PDF Version)
Varithena | (PDF Version)
VenaSeal | (PDF Version)
Ambulatory Phlebectomy | (PDF Version)

Patient Consent Forms (PDF)

Informed Consent Form for EVLA/RFA procedure
Informed Consent Form for Sclerotherapy procedure
Informed Consent Form for Varithena procedure
Informed Consent Form for VenaSeal procedure

Exceptional patients care is our first priority. If you have any questions about treatment or about your upcoming appointment, please call the Vein Healthcare Center at 207-221-7799. We are available to answer questions and address any concerns you may have.