A leader in vein treatment in the Coachella valley since 2001
PATIENT INTAKE FORMS
Please download and complete The following Patient Intake Form. Fax the completed form(s) to 760-610-5601 or bring them with you to your first appointment.
Faxing will expedite the process of determining insurance involvement if appropriate.
We accept the following forms of payment. VISA, Mastercard, American Express, Discover, Medicare, Cash, Personal Check. Insurance assistance provided.