Logo with the word "HOPE" in bold, dark letters next to a teal shape resembling a flame or leaf.

Book an appointment

A woman with long dark hair smiles while wearing a dark zip-up jacket with a "HOPE" logo on the left side. She is standing against a plain background.
Meet the team
One-of-a-kind multidisciplinary limb preservation practice
Vascular and Podiatric Surgeons working side by side for you
Advanced wound healing clinic with seemless integration of hyperbaric therapy
Over 20+ years of combined clinical experience
Over 2000+ legs saved!

Book an appointment


    Type of appointment:


    Appointment request form:


    Attach an image of your case

    Contact us

      How Can We Help You?

      We’re here to provide you with the best care and support. Please let us know what service you’re interested in or share more details about how we can assist you.





      Select the service you’re seeking:


      Do you have health insurance?


      How can we help you?

      Our team will get back to you promptly!

      Contact details
      • Victoria Clinic – Vascular
      • 101 James Coleman Drive, STE A Victoria, TX 77904
      • (361) 888 5554
      • El Campo Clinic – Vascular & Podiatry
      • 305 Sandy Corner Rd., Suite 210 El Campo, TX 77437
      • (979) 677 3343
      Office hours
      • Monday to Friday: 8:00 am to 5:00 pm
      Subscribe to our newsletter

      Subscribe to our newsletter for valuable health insights and clinic updates.

        Hope

        Home

        Our services

        About us

        Blog

        Copyright © 2024 | HOPE Vascular and Podiatry | All rights reserved.

        Privacy policy

        Terms & conditions

        Hope - Vascular and Podiatry

        Dr. Miguel F. Montero
        Vascular Surgery Patient Referral Form
        Please Fax this for to 346-205-0221

          Vascular Surgery Patient Referral Form








          Preferred contact name and number (if other than patient):



          Reason for referral:


          Referred by:







          Questions? Contact client services at 346-541-6421
          7501 Fannin St. Suite 600, Houston, Texas 77054

          Hope - Vascular and Podiatry

          Dr. Brian D. Lepow
          Podriatry Patient Referral Form
          Plase Fax this for to 346-205-0221

            Podiatry Patient Referral Form








            Preferred contact name and number (if other than patient):



            Reason for referral:


            Referred by:







            Questions? Contact client services at 346-541-6421
            7501 Fannin St. Suite 600, Houston, Texas 77054

            Hyperbaric Oxygen Patient Referral

            7501 Fannin St., Suite 600
            Houston, TX 77054

            • 346.541.6421
            • 346.205.0221
            • hcic.io
            Hope - Vascular and Podiatry

              Hyperbaric Oxygen Patient Referral





              Wound details

              Wound Location




              Additional information

              Schedule a meeting

                Interested in becoming part of our growing referral network?
                Please schedule a personalized visit with our business development team.
                Fill this form out to join the growing network of limb preservation specialists.


                Appointment request form:



                Vascular Surgery Patient Referral Form
                Podiatry Patient Referral Form
                Hyperbaric Oxygen Patient Referral
                Schedule a meeting with our senior business development team
                Hope - Vascular and Podiatry

                Registration Form

                  How did you hear about us?

                  I. Patient information:


















                  Emergency Contact:





                  **By providing an email you agree to receive updates, news, and general information from Hope Vascular & Podiatry. We respect your right to privacy and will not share your information.

                  II. Insurance information:

                  (Primary) please complete if other than self (Secondary)













                  III. Payment of Benefits:

                  I direct payment to Hope Vascular & Podiatry of the Surgical and / or Medical Benefits, if any, otherwise payable to me for their services as described, but not to exceed the reasonable and customary charges for those services.



                  IV. Release of information:

                  I hereby authorize Hope Vascular & Podiatry to release any information acquired during the course of my examination or treatment








                  Past Medical History



                  Please indicate if you have had any of the following by marking the corresponding check box:
















                  Past Surgical History

                  Please indicate if you have had any of the following by marking the corresponding check box:










                  Family History Select Family Member

                  MG: MATERNAL GRANDPARENTS | PG: PATERNAL GRANDPARENTS | M: MOTHER | F: FATHER | S: SIBLINGS















                  Social History Select one








                  Home Health Agency



                  Review of Symptoms

                  Please indicate whether you have experienced any of the following...




















                  Medication / Allergy History




                  Please list all MEDICATIONS you take routinely (including current and previous chemotherapy):

































                  HOPE Vascular and Podiatry

                  Consent Form

                  1. I hereby authorize, Dr Brian D. Lepow and/or Dr. Miguel F. Montero, and Anner Jimenez, NP to perform upon the named patient the following wound care and/or other treatment: Debride wound, removal of dead tissue, x-ray, labs/drawing blood, respiratory treatment and tests and the use of growth factors or other advanced technologies, as applicable. Dr Brian D. Lepow and/or Dr. Miguel F. Montero, and Anner Jimenez, NP has fully explained to me the expected benefits and complications (from known and unknown causes), attendant discomforts and risks that may arise, as well as possible alternatives to the proposed treatment and the anticipated results if the treatment is not performed. The treatment may include application of wound healing growth factors to improve healing. I have been given an opportunity to ask questions and all of my questions have been answered fully and satisfactorily.

                  2. Any specimens/tissues removed may be examined and retained by the testing laboratory and its authorized affiliate for medical, scientific or educational purposes and such specimens/tissues or parts may be disposed of in accordance with accustomed practice.

                  3. I acknowledge that no guarantees or assurances have been made to me considering the results intended from the wound care and/or other treatment.

                  4. I hereby consent that photographs, tape recordings, videotape and/or movies may be taken of the patient named in connection with the medical and/or other services the patient is receiving. I further consent that a history of my/the patient’s social and medical problems may be taken by HOPE Clinical Innovation Center. Videotapes are used for educational purposes only. Recorded video tapes are not part of my medical record. Such photographs, tape recordings, videotapes, videos and/or histories may be published, shown, exhibited or otherwise used by the provider and its authorized affiliate may deem proper. I understand that neither myself/the patient nor members of my/the patient’s family will be identified by name in connection with any use of this material.

                  5. I consent to the use of the information obtained during the course of my wound care treatment and stored in the HOPE Clinical Innovation Center’s database for the purpose of conducting research, and quality management activities. I understand that my identity will not be protected in any displays of this information at any time. I further agree that there are no restrictions placed on you or anyone related to the for the use of this information in the manner described above.

                  6. I request that payment to authorized Medicare benefits be made either to me or on my behalf for services furnished to me by the provider. I authorize any holder of medical information about me to be released to the Center for Medicare and Medicaid Services and its agents any information needed to determine these benefits or the benefits payable to related services. I understand that I am responsible for any amount not covered by insurance.

                  7. I agree to allow HOPE Clinical Innovation Clinic to send me automated text messages to the number I have provided for appointment reminders and discharge instructions.