Patient Forms

Thank you for selecting The Vein Institute & MediSpa in Humble, Texas for your venous care. To schedule an appointment, call us at (281) 312-0208 or use our online appointment request form.

Once you have made your initial appointment, you may pre-register online by completing the interactive forms below, or you may download and print the forms, fill them out, and bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.

Interactive Forms

• New Patient Registration
• Health History Form

Downloadable Forms

• New Patient Registration
• Health History Form

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.

Disclaimer: If you register, make an appointment or submit any other information online, all your information is transmitted securely and is held in strictest confidence, adhering to HIPAA guidelines and protecting your privacy.