• 847-259-8226
  • CLINIC : 1365 Wiley Rd #149, Schaumburg, IL 60173, USA
veincare-experts
  • About Us
    • Our Doctors
    • Our Staff
    • About Us
  • Treatments
    • VenaSeal™
    • ClosureFast
    • Endovenous Ablation Therapy
    • Sclerotherapy (chemical and foam)
    • Compression Therapy
    • Diagnostic Venous Ultrasound
  • VEIN CONDITIONS
    • Varicose Veins
    • Spider Veins
    • Restless Leg syndrome
    • Deep Vein Thrombosis (DVT)
    • Superficial vein Thrombosis (SVT)
    • Thrombophlebitis
  • Patient Education
    • Why You Should Choose Vein Experts
    • What is a Phlebologist?
    • What To Look For In A Phlebologist
    • Vein Conditions
    • Treatments for Varicose Veins and Venous Conditions
    • Glossary of Vein and Circulatory Terms
  • Patient Information
    • Frequently Asked Questions
    • Patient Forms & Instructions
    • Accepted Insurance Plans at VeinCare Experts
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Patient Forms & Instructions

Registration Packet for Vein Treatment

Welcome to our clinic! Below is the essential information and forms included in the registration packet for new patients.

Patient Forms

  • Patient Registration
  • Patient History
  • General Consent
  • Notice of Privacy Practices
  • Notice of Financial Policies

Instructions for Treatments

  • Compression Stocking
  • Sclerotherapy
  • EVLA
  • Phlebectomy

Consent Forms

  • Sclerotherapy
  • EVLA
  • Closurefast™ RF ablation
  • Venaseal™ Closure
  • Phlebectomy
  • Authorization for Release of Confidential Health Information
Patient Forms

Registration Packet

Patient Registration

Patient History

General Consent

Notice of Privacy Practices

Notice of Financial Policies

Instructions

Compression Stocking

Sclerotherapy

EVLA

Phlebectomy

Consents

Sclerotherapy

EVLA

Closurefast™ RF ablation

Venaseal™ Closure

Phlebectomy

Authorization for Release of Confidential Health Information

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At Vein Experts, our varicose vein specialists are experts in the evaluation and treatment of patients with varicose veins and related problems.

  • Phone : 847-259-8226
  • Address : 1365 Wiley Rd #149, Schaumburg, IL 60173, USA

PROCEDURES

Endovenous Ablation
Sclerotherapy
Compression Stocking
Ultrasound Evaluation

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Dr. Robin

Dean T. Velis
doctor Robin

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