Patient
Forms

We're looking forward to welcoming you for your appointment. Whether you're looking for details on our financial policies or detailed information about how to prepare for procedures, you can find everything you need to know below.

patient-resources

New Patient Information

As a new patient, your first visit will lay the foundation for our ongoing relationship and ensure you receive the best care possible. Here's what you need to know.

Medical Record Questionnaire

Understanding your medical history helps us provide better care tailored to your specific needs. Help us enhance your treatment by providing your information.

HIPAA Statement

HIPAA is designed to protect your sensitive health information from being disclosed without your consent or knowledge. Learn more by reading over our HIPAA forms.

Assurance of Privacy Practices

At The Heart House, we are committed to protecting your privacy. Learn more about how we require your consent to share any information with others.

Financial Policies

Learn more about our financial policies, including how we work with insurance providers, what types of payment we accept, how billing works, and more.

Release of Information

To facilitate your care, we require your permission to receive and release your health information. Help us deliver the best care by viewing and filling out the form in advance.

Notice of Privacy Information Practices

Read to understand how medical information about you may be used and disclosed and how you can access this information.
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Frequently Asked Questions

What can I do to stay heart-healthy and reduce my risk of heart issues?

The most important things you can do to prevent further heart issues and live a long, healthy life are:

  • Follow a heart-healthy diet low in saturated fat, trans fat, sodium, and added sugars. Eat plenty of fruits, vegetables, whole grains, lean proteins and healthy fats.
  • Aim for at least 30 minutes of moderate physical activity daily or as tolerated. Walking, swimming, and other aerobic exercise promotes heart health.
  • Take all prescribed medications to manage blood pressure, cholesterol, diabetes, and other conditions.
  • If you smoke, commit to quitting.
  • Limit alcohol intake.
  • Manage stress levels through yoga, meditation, counseling, or other outlets.
  • Get enough quality sleep each night.
  • Keep all follow-up care appointments to monitor your health.
The more diligently you follow heart-healthy lifestyle habits and manage other health conditions, the better you will feel. We are here to provide support and guidance every step of the way.

What causes high blood pressure and how can I reduce it?

High blood pressure, also known as hypertension, generally develops over time. Common causes include an unhealthy diet, inactivity, obesity, genetics, diabetes, and kidney disease. Getting your blood pressure checked regularly is essential in diagnosis, as high blood pressure typically has no signs or symptoms until it reaches a point where it becomes a hypertensive crisis. 

Lifestyle changes and medications can help lower your blood pressure. Our doctors will work with you to develop a plan to keep you healthy and feeling well.

What causes heart arrhythmias and are they dangerous?

Heart arrhythmias occur when the electrical impulses that coordinate your heartbeat become disrupted. There are different types, with some causes including:

  • Heart disease, high blood pressure, or prior heart attack that has damaged the heart’s electrical system
  • Congenital heart abnormalities present from birth
  • Imbalances in electrolytes like sodium, potassium, or magnesium
  • Effects of caffeine, alcohol, medications, or stimulants
  • Physical causes like sleep apnea or thyroid disorders
  • Stress or strenuous exercise

Sometimes, there is no identifiable cause for an arrhythmia. Whether an arrhythmia is dangerous depends on the type, frequency, and one’s overall heart health. Some may cause bothersome symptoms but are otherwise benign. However, certain arrhythmias can significantly raise the risk of stroke, heart failure, or sudden cardiac arrest. The good news is very effective treatments are available for most arrhythmias.

What are the symptoms of a heart attack?

A heart attack is a serious medical condition. If you suspect you may be having a heart attack, call 911. Common symptoms of a heart attack:

  • Chest pain or discomfort, often described as tightness, pressure, squeezing
  • Pain that radiates to the neck, jaw, shoulders, arms, or back
  • Shortness of breath, nausea, dizziness, sweating
  • Abdominal pain
  • Palpitations or irregular heartbeat
  • Fatigue for days leading up to an event

What tests will I need to diagnose my heart condition?

Common diagnostic tests include an EKG, echocardiogram, stress test, CT scan, or cardiac catheterization. The SWCVA team will recommend the appropriate tests based on your symptoms and medical history.

What are peripheral vascular conditions?

Peripheral vascular conditions affect the blood vessels outside of the heart and brain. Some common peripheral vascular conditions include:

  • Peripheral artery disease: A narrowing of the arteries that supply the legs, arms, stomach, or kidneys due to fatty plaques, causing pain, cramping, or fatigue in affected areas.
  • Deep vein thrombosis (DVT): A condition in which blood clots form in the body's deep veins, often the legs.
  • Chronic venous insufficiency (CVI): A condition causing impaired blood flow, leading to leg swelling and varicose veins.
  • Pelvic congestive syndrome: A common cause of chronic pelvic pain, this condition arises from problems with blood flow in pelvic veins.

At SWCVA, we can help diagnose and treat your peripheral vascular condition to ease your pain and help you get back to your life.

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