WISCONSIN VEIN INSTITUTE
1841 Ridge Road Suite 2 • Green Bay, WI • Phone: 920.884.VEIN (8346) • Fax: 920.884.7757 |
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PATIENT INFORMATION |
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Your First Visit at Wisconsin Vein Institute
We look forward to getting to know our patients. In order to provide the best care possible we will need some medical information about you.
At your initial consultation you will be asked to fill out a comprehensive medical and venous history form, supply us with the name and phone number of your Primary Physician as well as a copy of your insurance card or method of payment. |
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We will do a focused physical exam and may perform a screening Ultrasound to determine the type and extent of your varicose disease. We may also take photographs of your legs, which we will use in the follow-up to access your progress. Photographs may also be sent to your insurance company as part of their requirement for pre-Authorization for treatment.
Once the exam is complete, we will discuss your options for treatment as well as estimate the number of sessions. You may also be measured for graduated compression hose. |
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| We will work with your insurance company to help determine coverage as well as estimate your out of pocket expense. This may take several days to weeks depending on your insurance company. In order to make your first visit productive, please bring the following items: |
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A comfortable/old pair of loose fitting shorts. |
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Your Primary Physician's name and phone number. |
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You will need to fill out several forms prior to being seen even if you are here for treatment of spider veins. To make this process easier, please click here for a printable PDF patient form link below. You can then fill them out and bring them with you on your first visit. |
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Please bring your Insurance Card, if you have one. |
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Please note that we will be able to see you whether or not you bring the above items. |
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