Lafayette Regional Vein Center - Indiana

Forms for Patients

Speed Up Your Visit!

The Lafayette Regional Vein Center understands there is a lot of paper work associated with medical treatment. That is why they have included the following resources to conveniently speed up the administration process.

Patient History Form

Download the PDF File: PatientHistoryForm.pdf

Patient Information Form

Download the PDF File: PatientInformationForm.pdf

ShawnShawn was concerned about insurance.
“They called my insurance company and took care of those issues. I just needed to show up for the appointments. My leg feels great!”