New Patient Forms
In order to help our team prepare for your office visit, please complete the following forms and bring them to your next appointment. This will help to streamline the check-in process and ensure our files are up-to-date. If you have any questions, please feel free to contact your Piedmont Physician’s office.
Southern Vein Care accepts most major insurance plans. Current insurance plans in which we participate in are below. If you do not see your plan or have a question about your specific plan, please call us or call your insurance company.
|NAME OF PLAN||TYPE OF PLAN|
|Blue Cross Blue Shield of Georgia||HMO/POS/PPO/Open Access|
|CIGNA Healthcare of Georgia||HMO/POS/PPO/Open Access|
|Great West Healthcare (OneHealth)||HMO/POS/PPO/Open Access|
|Private Healthcare Systems (PHCS) (NOT Multiplan)||PPO|
|United Healthcare||HMO/POS/PPO/Open Access|
A Few Important Reminders
- Knowledge and proof of current insurance is the patient’s responsibility. Please bring your insurance card with you each time you come to see the physician.
- It is ultimately the patient’s responsibility to understand coverage and to ensure payment is made for service provided.
- If there is no verifiable insurance, services are provided on a “self-pay” basis. Self-pay services must be paid in full at the time services are provided. For your convenience, payments can be made by cash, check, or credit card. We accept MasterCard, Visa, American Express and Discover Card.
Support Hose Information and Links
- C.H. Martin | Phone: 770-719-3110 Fax: 770-719-3109
101 Devant Street, Suite 402, Fayetteville, GA 30214
- David’s Drug and Surgical Shop | Phone: 770-227-2571
315 South 8th Street, Griffin, GA 30224
- Christian’s Medical Equipment & Supplies | Phone: 404-362-6901
105 C Main St., Forest Park, GA 30297
- AeroCare (Carmichael’s) | Phone: 770-832-1227
109 Regen Drive, Carrollton, GA 30117
- Dunwoody Pharmacy | Phone: 770 455-1144
4675 N. Shallowford Rd., Dunwoody, GA 30338
- Piedmont Compression Therapy | Phone: 404-605-2556
1968 Peachtree Road, Building 77, Atlanta, GA 30309
- ADA Medical Supply | Phone: 678-398-0505
4968 Austell Road, Austell, GA 30106
- Sigvaris | Phone: 770-631-1778
1119 Hwy. 74S, Peachtree City, GA 30269
- Smith & Davis Clothing | Phone: 770-487-4183
1552 Highway 54 W, Fayetteville, GA 30214
- Piedmont Wellness | Phone: 678-289-7100
200 J. Arthur Ave., Fayetteville, GA 30214
- Jay’s Medical Supplies
145 Governors square Suite E, Peachtree City, GA 30269
- Lambert’s Pharmacy | Phone: 470-414-7644
15 Thomas Graces Annex Suite 150, Sharpsburg, GA 30277
- Thompson’s Pharmacy | Phone: 770-251-4808
134 Millard Farmer Industrial Blvd., Newnan, GA 30263