Free R.N. evaluation. Call today!
1455 W. Chandler Blvd, Suite B-11
Chandler AZ 85224
info@bellagioveinclinic.com
Tues-Sat: 9am - 5pm
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"Bellagio Vein Clinic and Med Spa is very professional and caring. They made me feel comfortable and were always making sure I was feeling okay. My EVLT procedure was over before I knew it and the staff was quick to answer any of my questions or concerns. I HIGHLY recommend them!" - Angelina Aparo, 35, Phoenix AZt - 212.593.9800
f - 212.593.5757
e - nycitydoc@aol.com
www.Cosmetic-Vein-Solutions.
www.MedicalAssociatesNY.com
Please print, fill out, and bring the necessary forms below in order to reduce your waiting time. Thank you.
REQUIRED FOR ALL PATIENTS
SELECT ONES PERTAINING TO YOU
Consent & information for Laser Spider Vein treatment
Consent for EVLT / MicroPhlebectomy
Consent for Surgeries (non-specified)
Varicose Vein Insurance Questionnaire
CLINIC REFERENCE INFO