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Patient Education, Consent, History, and Physical Forms

An efficient office-based vein practice requires a completely separate set of forms than other medical/surgical practices. Patients with varicose veins are unique compared to the other patients in your practice. They are usually younger, healthier, more self-conscious and have greatly different concerns and expectations compared to patients with other medical disorders. There are differences in the relevant parts of their history and physical and they often require more education about their condition since it is elective. They want to see educational materials unique to varicose veins and endovenous ablation. Consent forms list completely different lists of possible complications which are less life or limb-threatening and more cosmetic in nature.

H&P forms should be more problem focused but must include all relevant components of a venous history (prior DVT, vein stripping, lidocaine allergy, chronic edema etc). These forms also need to be simple and document Medicare and insurance company guidelines for reimbursement.

Educational Materials/Forms Included in Standard Package:

  • Sample Magazine Articles
  • Venous History and Physical
  • Sclerotherapy Consent
  • Endovenous Ablation Consent
  • Varicose Vein Education Booklet
  • Patient/Physician PowerPoint Presentations
  • Sclero/Consultation Gift Certificates
  • Venous Insufficiency Educational Booklet
  • Sample Letters of Medical Necessity
  • Operative Notes
  • Patient Pre/Post Operative Instructions
  • CPT/ICD-Q Coding and Ins Co. Policies

We will provide you with a CD of a complete set of forms that you can customize with your practice information and that are specific to an office-based vein center. Our detailed forms include a simple check box format that includes the information necessary for Medicare and private insurance carrier authorization. For example, Medicare and most insurance companies require that patients have attempted medical management with weight control, elevation and compression stockings for 3-6 months. Our forms include all of the documentation required for a level 3 consult or new patient visit in addition to the important list of topics reviewed with the patient (eg. risks and alternatives of endovenous ablation, review of ultrasound, patient attempts at conservative treatment etc).