Contact us today.

We ask new patients to open, download, and print the Patient Registration Form and the gender-appropriate Medical History Form provided below. Please complete these forms and bring them with you to your initial office visit.

Please also bring your insurance card and a government-issued photo identification card.


New Patient Registration

Click Here to Download the Patient Registration Form

New Patient History – Women

Click Here to Download the New Patient History for Women

New Patient History – Men

Click Here to Download the New Patient History for Men

  • Free New Patient Consultation Call

  • An Independent Physician Owned Specialty Practice Located on the Tennova Healthcare CampusSEE MAP AND DIRECTIONS
  • Patient Testimonials

    "For almost a year, I thought the burning and hurting was caused from a nerve. After the vein was removed, I was back at work in seven days. I can’t thank Dr. Daugherty enough." -- R.M.

    Questions About Insurance Coverage?

    CLICK HERE FOR MORE INFORMATION

    Men Have Varicose Veins Too

    CLICK HERE TO FIND OUT MORE