Ozark Regional Vein Center

Ozark Regional Vein Center

Vein Clinic479-777-8014
Aesthetics479-668-0168
  • Home
  • About Us
    • About Renew Aesthetics
    • The Dr. Haney Difference
    • Meet Dr. Kevin Haney
    • Meet Aimee Burrous, APRN
    • Meet Amber, Med Spa Coordinator
    • Meet Amy, LMA
    • Meet Jeannette, APRN
    • Meet Kendra, RN & MA
    • Meet Krystle, Aesthetician
    • Office Tour
    • Professional Societies
    • Careers
  • Aesthetic Services
    • Virtual Consultation
    • EMSCULPT
    • Renew Aesthetics Prices
    • Injectables
      • Botox
      • Xeomin – The latest option for frown lines
      • Fillers: Belotero
      • Fillers: Juvederm
      • Fillers: Radiesse
      • Fillers: Restylane
      • Kybella
    • Skin Tightening/Body Contouring
      • BTL Vanquish ME
      • Exilis Ultra for Non-Surgical Skin Tightening
      • EMSCULPT
      • Legend Pro by Lumenis
    • Vaginal Rejuvenation
    • Skin Rejuvenation
      • Visia Complexion Analysis
      • Hydrafacial MD
      • Chemical Peels
      • Chemical Peel: VI Peel
      • Dermaplaning
      • Facials/Extractions
      • Legend Pro
      • Microdermabrasion
    • Hair Removal
      • Light Sheer Desire (Laser Hair Removal)
      • Waxing Services
    • miraDry
    • Sclerotherapy
    • SkinCeuticals
    • Tanning Lotion and Body Scrub Treatments
    • Treatment for Skin Conditions
    • Wellness
      • B12 Shots
      • Hormones
      • IV Infusion
      • Nutrafol
      • Supplements
      • Weight Loss
  • Before & After
  • Patient Resources
    • VIP Program
    • New Patient Forms
  • Testimonials
    • Reviews
    • miraDry Testimonials
    • Doctor.com Testimonials
  • Blog
    • News
  • Specials
  • Gift Cards
  • Contact Us

New Patient Forms

Initial Consultation Forms

Please download and fill out the forms and bring them with you to your visit. Please allow a few moments for multi-page form download.

  • Patient Registration [Download PDF]
  • Health History Form [Download PDF]
  • Patient Payment Responsibility Form [Download PDF]
  • Office Consent Form [Download PDF]
  • Notice of Privacy Practices [Download PDF]

Procedural Forms

Sclerotherapy

  • Sclerotherapy Consent [Download PDF]
  • Sclerotherapy Pre-Op Instructions [Download PDF]
  • Sclerotherapy Post-Op Instructions [Download PDF]

Radiofrequency Ablation

  • RFA Consent [Download PDF]
  • RFA Pre-Op Instructions [Download PDF]
  • RFA Post-Op Instructions [Download PDF]

Ambulatory Phlebectomy

  • Ambulatory Phlebectomy Consent [Download PDF]
  • Ambulatory Phlebectomy Pre-Op Instructions [Download PDF]
  • Ambulatory Phlebectomy Post-Op Instructions [Download PDF]

Formas de Procedimiento

  • Regimen Despues del Tratamiento [Descargar PDF]

Escleroterapia

  • Instrucciones de Escleroterapia Post-Procedimiento [Descargar PDF]

Ablación

  • Instrucciones de Ablación Post-Procedimiento [Descargar PDF]

Flebectomía Ambulatoria

  • Instrucciones de Flebectomía Ambulatoria Post-Procedimiento [Descargar PDF]

Make an Appointment

Consult Form

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Location

Ozark Regional Vein Center
5433 W. Walsh Lane, Suite A
Rogers
Arkansas 72758
Phone: 479-777-8014

Fax: 479-464-9046

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