Click here to Download, Print and Complete the linked paperwork and either mail to our office or bring in on the date of your visit. Please also have the following items with you if they apply:

•  Insurance Card or Cards
•  Photo Identification*
•  Arteriogram Films and Report
•  Ultrasound Report
•  CT Films and Report
•  MRI/MRA Films and Report
•  Blood Work Reports
•  Any Arm or Leg Circulation Test Reports
•  Prescription for vascular test ordered by your doctor

* If the patient is a minor: photo identification of the patient’s responsible party will be obtained.
* If you do not have a valid photo ID: Please bring two forms of non-photo ID, one of which is issued by a state or federal agency i.e. birth certificate, social security card, voters registration card, permanent residence card or “green card”, etc.

If you are required by your insurance company to have a referral from your primary care physician, it is your responsibility to obtain this prior to your appointment. If you are unsure whether your insurance requires a referral, it is your responsibility to find out either from your insurance company or your primary care physician.

Please notify the office at least 24 hours prior to your appointment if you must cancel or reschedule for another
day.