Thank you for choosing Symmetry Laser Vein Center for a consultation with Dr Tapper a Board Certified Vascular Surgeon regarding your varicose veins.

Please print the following forms and bring to your appointment.

• Patient Demographic
• Venous Medical History
• Consent for Treatment, Payment & Healthcare Operations
• Patient Signature Malpractice Letter

The forms below are for your information. You do not have to bring these forms to your appointment.

• Appointment Cover Letter
• Financial Policy
• Notice of Privacy Practices

We do participate with many major health insurance companies; co payments, deductibles & patient responsibility as directed by your plan will be collected at time of service. We suggest you call your insurance company for your benefits and policy requirements.

Patients are responsible for obtaining the required referrals from your Primary Care Physician, referrals must be received prior to your appointment or your appointment will be rescheduled.

Your insurance benefits will be verified by our office prior to your appointment. Symmetry Laser Vein Center is not responsible for inaccurate benefit information provided to us from your insurance company’s customer service dept; we urge you to be familiar with your insurance benefits by calling your insurance company prior to your appointment. (See financial policy).