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OPEN: Sclerotherapy Nurse
Medical Office Assistant

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Compression Garments

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Skin Care & Repair

APPOINTMENT FORM:

First Name*

Last Name*

Email*

Preferred Contact Number*

Date of Birth*

Address*

City*

State*

Zip Code*

Schedule Type*

Schedule In Office

Schedule Telehealth Appointment From Your Home

Reschedule

Preferred Day

Mon

Tues

Wed

Thurs

Fri

Preferred Time

Morning (9AM - 10:45AM)

Afternoon (1:30PM - 3:45PM)

Briefly Describe Your Concern*

Primary Care Physician

Insurance Name

Insurance ID Number

Primary Policy Holder

Primary Policy Holder DOB

How Did You Hear About VSC?*

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CHARLOTTE, NC

Phone

980-890-8356

Address

15825 Ballantyne Medical Place
Ste. 240
Charlotte, North Carolina 28277

Schedule Appointment, Vein Specialists of the Carolinas



Phone

980-890-8356



CHARLOTTE, NC

15825 Ballantyne Medical Place
Ste. 240
Charlotte, North Carolina 28277

980-890-8356

GASTONIA, NC

Phone

980-890-8356

Address

860 Summit Crossing Place
Ste. 120
Gastonia, North Carolina 28054

Schedule Appointment, Vein Specialists of the Carolinas



Office Hours

Mon.-Thurs: 7:30am – 4:30pm
Friday: 7:30am-12:30pm



GASTONIA, NC

860 Summit Crossing Place
Ste. 120
Gastonia, North Carolina 28054

980-890-8356

Schedule Appointment, Vein Specialists of the Carolinas

Dr. David Draughn, MD,
FACS, RVT, RPVI, RPhS

Schedule Appointment, Vein Specialists of the Carolinas

Schedule Appointment, Vein Specialists of the Carolinas

Schedule Appointment, Vein Specialists of the Carolinas

APPOINTMENT FORM:

First Name*

Last Name*

Email*

Preferred Contact Number*

Date of Birth*

Address*

City*

State*

Zip Code*

Schedule Type*

Schedule In Office

Schedule Telehealth Appointment From Your Home

Reschedule

Preferred Day

Mon

Tues

Wed

Thurs

Fri

Preferred Time

Morning (9AM - 10:45AM)

Afternoon (1:30PM - 3:45PM)

Briefly Describe Your Concern*

Primary Care Physician

Insurance Name

Insurance ID Number

Primary Policy Holder

Primary Policy Holder DOB

How Did You Hear About VSC?*

Processing...

CHARLOTTE, NC

Phone

980-890-8356

Address

15825 Ballantyne Medical Place,
Ste. 240
Charlotte, North Carolina 28277

Schedule Appointment, Vein Specialists of the Carolinas



Phone



CHARLOTTE, NC

15825 Ballantyne Medical Place
Ste. 240
Charlotte, North Carolina 28277 28054

980-890-8356

GASTONIA, NC

Phone

980-890-8356

Address

860 Summit Crossing Place
Ste. 120
Gastonia, North Carolina 28054

Schedule Appointment, Vein Specialists of the Carolinas



Office Hours

Mon.-Thurs: 7:30am – 4:30pm
Friday: 7:30am-12:30pm



GASTONIA, NC

860 Summit Crossing Place
Ste. 120
Gastonia, North Carolina 28054

980-890-8356

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Dr. David Draughn

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