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DOCUMENT DOWNLOADS

All patients should complete the following forms and submit them to our office prior to the initial consultation. Please download each file, print, and fully complete them.  You can e-mail, fax, or postal mail them. You can choose to also bring them to your initial consultation.

 

If you have any questions, please call our main office at 1.847.550.0020.

DOWNLOAD FORM

Format: .DOC (Microsoft Word)

VERSION EN ESPAÑOL

Registration Form

FORMULARIO DE INSCRIPCIÓN

DOWNLOAD FORM

Format: .DOC (Microsoft Word)

VERSION EN ESPAÑOL

Questionnaire

CUESTIONARIO INICIAL

© Copyright 2014-2016 Vein Care Specialists, Ltd. All rights reserved. Not all patient candidates will qualify for treatment. Main Office: 27401 W. IL Route 22, Suite 106, Barrington, IL 60010

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