Initial Consultation Forms
Please download and fill out the new patient forms and bring them with you to your visit. Please allow a few moments for multi-page form download.
Directions: For individual forms, please click the “Download” button if the form opens in your web browser. Open this form on your computer, fill it out, save, and send it back or print it out and bring it in with you. Download All Forms (will download as a .ZIP file)
- Patient Intake Form [Download PDF]
- Medical History Form [Download PDF]
- Venous History Form [Download PDF]
- Consent Form [Download PDF]
At the Waterford Vein Institute of
Directions: Please click the “Download” button if the form opens in your web browser. Open this form on your computer, fill it out, save, and send it back or print it out and bring it in with you.
- Sclerotherapy Consent Form [Download PDF]
- Ambulatory Phlebectomy Consent Form [Download PDF]
- Radiofrequency Ablation Consent Form [Download PDF]
Pre-Procedural Care Forms
What to expect before your procedure: Before your procedure, Dr. Waterford will provide you with a detailed guide on how to prepare for your treatment. Please click on the links above to find pre-procedural care for varicose vein treatments.
- Sclerotherapy Treatment [Download PDF]
- Ambulatory Phlebectomy Treatment [Download PDF]
- Radiofrequency Ablation Treatment [Download PDF]
Post-Procedural Care Forms
What to expect after your procedure: Unlike traditional vein stripping, which requires weeks for recovery, our state-of-the art vein treatments only require a few days of light activity. After your procedure, Dr. Waterford will provide you with a detailed guide to your post operative care. Please click on the links below to find a treatment overview for varicose and spider vein treatments.
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