PATIENT FORMS
We ask all new patients to complete these forms before the first appointment. Please download, print, and bring the completed forms with you—or you can arrive 20 minutes early to your appointment and complete the forms in our office.
AM I A CANDIDATE?
Can Pinnacle Vein and Vascular Center help you to reach peak health?
Yes!—especially if you answer yes to any of these questions:
CIRCULATORY SYMPTOMS
Legs that feel weighted, stiff, and tired — as if the legs are hard to lift and move forward. It might almost feel as if you’re dragging around a 5-pound weight.
Itching is an intense, distracting irritation or tickling sensation that may be felt all over the skin’s surface, or confined to just one area
While a poor skin condition could be due to many reasons, a poor blood circulation is definitely going to show up as poor skin condition.
Tired, heavy legs, spider veins, and tingling calves indicate that it’s high time to take action: aedema (slight swelling of the lower legs) may take place.
Uncomfortable (creeping, tingling, twitching, aching, throbbing, prickling,) sensation in the calves that occurs while sitting or while lying down.
A prickly sensation in the skin or a body part, accompanied by diminished sensitivity to stimulation of the sensory nerves.
A loss of the sensation of feeling in an area of the body.
SCHEDULE AN APPOINTMENT
It’s easy to schedule an appointment at Pinnacle Vein and Vascular Center.
Simply complete the form below, and our scheduling coordinator will call you to set an appointment your convenience. Or, call us at 1.888.553.VEIN(8346)
Insurances Accepted
Please call us at 888.553.VEIN to verify your insurance coverage.
Your 1st Visit

FREQUENTLY ASKED QUESTIONS
Varicose veins are enlarged, ropy veins, usually dark purple or blue in color, and most commonly appearing in the legs and feet. They gradually develop valves in the vein weaken from age or pregnancy, and blood that should be moving toward the heart flows backward and pools in the vein.
For some people, varicose veins are a cosmetic concern—while for others, they may cause pain, discomfort, throbbing or itching, and can indicate the risk of other vascular problems.
Treatment for varicose veins can involve some basic self-care practices, as well as minimally invasive therapies to collapse or remove the problematic vein and restore healthy blood flow.
Providers at Pinnacle Vein and Vascular Center provide careful pain management, and patients are often able to resume normal activities the same day or within several days, depending on the treatment.
Venuous disease, also known as venous insufficiency, is a condition in which the valves in the vein weaken, and allow blood that should be moving toward the heart to flow backward and pool in the vein, often in the legs or feet.
Spider veins are a common and less severe version of varicose veins—usually smaller and closer to the surface of the skin.
Spider veins—a common and less severe version of varicose veins—can be caused:
-When vein valves malfunction and blood pools in the vein
-By hormonal changes
-By sun exposure
-By pregnancy
Treatment for spider veins can involve some basic self-care practices, as well as minimally invasive therapies to collapse or remove the problematic vein and restore healthy blood flow.
Providers at Pinnacle Vein and Vascular Center provide careful pain management, and patients are often able to resume normal activities the same day or within several days, depending on the treatment.