Patient Forms

Vascular Surgical ASsociates & Wound 360 Forms

New Patient Form

New Patient HIPPA Form

Acknowledgement of Receipt of Privacy Practices

Patient Form Fee Guidelines

Cancellation and No-Show Policy

Patient Code of Conduct Policy

Prosthetics Center Forms

New Patient Form

Sclerotherapy Form

Cosmetic Laser Form

Prosthetics Center Forms

New Patient Form

Above Knee Home Exercise Program

Above Knee Sock Volume Management

Below Knee Home Exercise Program

Below Knee Sock Volume Management

Gel Liner Care and Instructions

Media Release Form

ACCEPTED INSURANCE

A list of accepted insurance companies is available from Vascular Surgical Associates. Many insurance companies generally cover the cost of the procedures offered by Vascular Surgical Associates (after co-pay and deductible requirements are met) if it is considered medically necessary. Cosmetic procedures are generally NOT covered. The doctor or his assistant will discuss with you whether they feel your treatment is medically necessary or cosmetic. You can always contact your insurance carrier to review their policy and coverage limits. The staff of Vascular Surgical Associates will assist you with all insurance paperwork.