Patient Instructions
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Pre-visit Forms
- Advance Beneficiary Notice of Noncoverage
- Contracted Insurance as of 8/1/2010
- Financial Policy for Northern Arizona Vein Center
- Patient Medical History
- Patient Registration
- Physician Direct Financial Interest
- Vein Worksheet
- Directions to Northern Arizona Vein Care Center
Download pdfs from this list
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Consent Forms
- Endovenous Laser Treatment Consent Form
- Informed Consent: Ambulatory Phlebectomy and Ultrasound Guided Sclerotherapy
- Sclerotherapy Consent Form
- Spider Vein Laser Treatment Consent Form
Download pdfs from this list
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Post Op Instructions
- Ambulatory Phlebectomy Instructions
- Post Operative Vein Treatment Instructions
Download pdfs from this list
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Patient Information
- Spider veins and treatments slide show
- Varicose veins and treatment options slide show
- Venous Mapping Ultrasound
- What to expect during your endovenous laser ablation
Go to slide shows from this list
- Please download any of these forms before or after your procedures with Northern Arizona Vein Center.
- All treatments provided by board certified surgeon Brian Schilperoort MD, FACS
- Over 20 years of vascular surgical experience
- Over 13 years of ultrasound expertise
- Over 1,000 endovenous procedures performed