Thank you for choosing the Center for Vascular Medicine. You will find links below to our new patient forms and patient handbooks.
Our staff is committed to the long-term treatment, monitoring and prevention of your Peripheral Arterial Disease (P.A.D.), a chronic but treatable ailment. We do our utmost to provide immediate interventional care that may provide some relief to symptoms. And take pride in offering the most advanced and patient-focused diagnostic and therapeutic modalities for the treatment of PAD.
Our practice is rooted in the words of Mahatma Gandhi: “A customer is the most important visitor on our premises. They are not dependent on us. We are dependent on them. They are not an interruption in our work. They are the purpose of it. They are not an outsider to our business. They are a part of it. We are not doing them a favor by serving them. They are doing us a favor by giving us an opportunity to do so.”
New Patient Resources
Please use the links below to download our new patient forms and patient handbooks. We ask that you complete the forms prior to your first visit to help expedite the registration process.
- New Patient Forms
- Patient Authorization Release Form
- Angiogram Brochure – English
- Angiogram Folleto – Spanish
- Venogram Brochure – English
- Venogram Folleto – Spanish
Included in the New Patient Forms
- Patient Information Form – this includes your insurance information for us to register you with our practice.
- Medical Information Form – this form is to explain your previous medical history and includes a medication and allergy list.
- Consent for Disclosure of Protected Health Information – we will only share information with the physicians that have reasons to know for medical treatment, unless otherwise instructed by the patient.
Please also bring the following documents to your first visit so we can make copies for our records:
- A photo ID such as a Driver’s License, State ID, Military ID, etc.
- Your current insurance cards
- Your referral slip from your Primary Care Physician (if required by your insurance plan)
If you have any questions, please call our office at (301) 276-7379 .