Thank you for choosing the Vascular & Leg Center in Bakersfield, California. You will find links below to our new patient forms and patient brochures.
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 Form (English)
New Patient Form (Español)
Included in the New Patient Forms:
There are 9 pages included in our New Patient Form Packet. This includes:
- Patient Information Form – includes you insurance information for us to register you with our practice.
- Physician-Patient Arbitration Agreement
- Patient Rights & Responsibilities
- Ownership Disclosure
- Medical Records Request/Release
- Consent Form for Use of Photographs, Videos & Personal Medical Information
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 888.918.3137