Fayetteville Vascular and Vein Center, P.A. wants your visit to be as pleasant as possible. If you are a new patient, we ask that you download and complete the forms packet included in this section and bring the forms with you to your visit. Please arrive 30 minutes prior to your appointment in order to allow adequate time for the registration process.
Although we will strive to see you as close to your appointment time as possible, please understand that our physicians do have emergencies from time to time that could cause a delay.
Should you have any additional questions, please do not hesitate to call our office. If you have billing questions, please call 1-800-990-6015.
If you are having difficulty viewing and printing the forms, then you may need to download and install the latest free version of Adobe Acrobat Reader.
New Patient Forms Packet
Please print and complete this forms packet before your appointment and bring it with you to your appointment.
- New Patient Forms (14 pages )
Individual Patient Forms
If you need an individual form from the New Patient Forms packet above, please choose from the list below.
- Health History
- Demographic Information
- Patient Consent
- Patient Information Worksheet
- Payment Policy
- Patient Rights & Responsibilities
- Notice of Privacy Practices
- Notice of Privacy Practices Acknowledgement
- Vein Questionnaire
- Information Release Authorization Form
- Glossary of Terms
- Health Insurance Glossary of Terms
To receive a copy of your medical records, please complete the Information Release Authorization Form and mail or bring it to the office or fax it to our office at (910) 401-0210.
Insurance & Billing
It is our goal to avoid any miscommunication or concerns regarding financial matters in order to focus our energies on providing healthcare services to our patients. Here you will find our billing policy with a list of insurance plans that we accept.