Health History Form
This form is to be filled out by physicians and health care professionals looking to refer a patient to The Texas Cardiac & Vascular Institute.
All submissions are HIPAA compliant and all PHI password protected. Give us a call at your preferred location if you have any questions.
The Texas Cardiac & Vascular Institute specializes in treatment and intervention for:
- Peripheral Artery Disease
- Critical Limb Ischemia
- Limb Salvage techniques & Amputation Prevention
- Edema
- Venous wounds
- Iliac vein compression
- Deep Vein Thrombosis
- Vascular Access
- AV Fistulas/Grafts
- General Cardiology
- Hypertension
- & More