Healthy Aging Forms

We value your time.

Completing the appropriate paperwork prior to scheduling your consultation will help us answer questions you may have regarding cost, specific conditions, procedures or anything else you might need.

Click the links to download printable and electronic versions of the consultation forms

Healthy Aging - Male Questionnaire (eForm)
Healthy Aging - Female Questionnaire (eForm)
Healthy Aging - Male Questionnaire (Paper)
Healthy Aging - Female Questionnaire (Paper)
Healthy Aging - Free Consultation Form (eForm)
Healthy Aging Free Consultation Form (Paper)

Free Consultation

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What the press is saying about us

Inside Kass Clinics

“I have had nothing but exceptional service and quality at your clinic.”

– MG
“Not only are you (Dr. Kass) , Bonnie and your staff highly educated and qualified and professional I always feel “like family” at your clinic”

– FT
“Dr. Kass, thank you very much for the professional courtesy towards my EVLT procedure. I especially appreciated your generosity during these economic times since things have been more challenging for us budget-wise too. I also wanted to let you know how much I respect your expertise in treating my varicose veins and I can tell that you are highly trained and skilled. I also respect how well you fielded all my questions and took the time to answer them as well. I will continue to highly recommend you and your staff to anyone who may need your services. I also enjoyed your sense of humor! You make me laugh.”

– MAB
“Dr. and Bonnie Kass, I wanted to take a moment to thank you for making this (at times scary) process easier. Your knowledgeable and lighthearted atmosphere were a refreshing change in an often over clinical and impersonal medical world. My legs feel better than they have in years and best of all I know that they are healthier than they have been in a very long time.”

– LO
“Dr. Kass, thank you so very much on such a generous discount on my vein procedures. That was truly unexpected but very appreciated! I will be back for sclerotherapy just as soon as school is out and I’m back from my vacation. I cannot thank you enough! Have a wonderful Spring!”

– KP
“Dr. Kass and Staff, thank you so much for the wonderful service and fun bedside manner! It was fun to be in the operating room with you and Angie and I never thought I would say something like that about a medical procedure!! My legs are feeling GREAT and I hope to see you again soon to finish up everything. Thank you! Thank you! Thank you!”

– DS
“Dr. Kass, I wanted to tell you how much I appreciate your generosity with clearing my account. I was so surprised and so relieved. I hope that you had a wonderful holiday season and that you have a fantastic 2010! Thank you!”

– AN
“Dear Dr. Kass, thank you so very much for all of your kindness as reflected in your graciousness about my bill- Your generosity is so appreciated and I want you to know that I am so blessed to have met you and enjoyed your expertise! I will get back in to see you before I leave for Texas…it’s not time yet …In the meantime- Enjoy the Summer! With Gratitude and Grace.”

– Rachel
“Dear Dr. Kass, thank you so very much! Thank you for my “Legs by Kass” – just in time for my son’s wedding this Friday.”

– SM
“Hi Bonnie, I just wanted to let you know that the last vein zapping/bruising treatment did the trick, and the last of those stubborn veins are finally gone! It is such a thrill to me now to not have those darn veins on my nose to cover up! I just want to thank you for all your extra care and effort you gave me, it is so much appreciated! I hope those veins stay away for a while, but at least I know where to go when they come back! Thanks Again!”

– MM

Healthy Aging

Healthy Aging Forms

We value your time.

Click the links to download printable and electronic versions of the consultation forms

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