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Protect your feet. Prevent amputation.

Every year, thousands of people lose a limb to wounds that could have been prevented.

At HOPE Amputation Prevention Center, we help you detect early signs of diabetic foot complications, before it’s too late.

Because every limb saved is a life transformed

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    Blog

    Circulation Problems in Port Lavaca? Vascular Care Is Now Available Locally

    HOPE Amputation Prevention Center now offers dedicated vascular care in Port Lavaca, TX — for patients whose main concern is circulation, not a wound.
    Read more
    Diabetic Wound & Vascular Care in El Campo You Don't Have to Drive to Houston

    Diabetic Wound & Vascular Care in El Campo: You Don’t Have to Drive to Houston

    HOPE Amputation Prevention Center now offers coordinated vascular, podiatry, and wound care in El Campo, TX — no trip to Houston required.
    Read more
    From Referral to Recovery What to Expect at a Coordinated Limb Preservation Clinic

    From Referral to Recovery: What to Expect at a Coordinated Limb Preservation Clinic

    Wondering what a visit to a coordinated limb preservation clinic looks like? Here's what to expect from referral to recovery at HOPE Amputation Prevention Center.
    Read more
    Charcot Foot in Diabetics Signs, Risks, and Treatment in Houston

    Charcot Foot in Diabetics: Signs, Risks, and Treatment in Houston

    Charcot foot is a serious diabetic complication that can go unnoticed until deformity sets in. Learn the early signs and treatment options.
    Read more
    Amputation Statistics in Houston & Texas Why Coordinated Care Changes the Outcome

    Amputation Statistics in Houston & Texas: Why Coordinated Care Changes the Outcome

    Amputation rates in Texas have risen in recent years — but early, coordinated care can change that trajectory. Here's what the data shows.
    Read more
    Hyperbaric Oxygen Therapy for Diabetic Wounds What Houston Patients Should Know

    Hyperbaric Oxygen Therapy for Diabetic Wounds: What Houston Patients Should Know

    Hyperbaric Oxygen Therapy (HBOT) helps chronic diabetic wounds heal by boosting oxygen delivery. Here's how it works and who qualifies.
    Read more
    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:



            Healing goes beyond the physical.

            HOPE Alliance is a support program designed to help patients and their families navigate the emotional and mental challenges that come with limb-threatening conditions. Through education, support groups, and meaningful connections, we create a space where you feel heard, supported, and not alone.

            Join HOPE Alliance and stay connected to upcoming events, resources, and support opportunities.


              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.