Please print, fill out and bring the following forms to your first appointment. PDF Form Download. The following forms are included in the above download packet:

HIPAA Consent Form
Patient Information Form
Patient History Form
Insurance Form


When performed for medical reasons, varicose vein treatment is covered by many insurance companies. The removal of spider veins, usually done for cosmetic reasons, is not generally covered by insurance. We can check with your insurance company to determine which treatment options are covered under your plan.

Most carriers (including Medicare) provide coverage for the varicose vein procedures. One of our goals at LHW is to assist patients in obtaining coverage for the venous procedure for resolution of venous reflux disease. Coverage for these procedures is subject to the terms of your coverage policy. Co-payments and deductibles may be applied.

We have dedicated patient financial coordinators to assist you. We don’t want any surprises because you will know what you owe up front. We accept Medicare and most major insurance plans and have financing options available if needed.

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