Patient Forms2018-02-18T23:12:43+00:00

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

Full Time LVN

January 17th, 2019|0 Comments

Local Surgery Center looking for a full time LVN with at least 2 years experience! Must have current LVN license and CPR certification. Monday - Friday! No weekends!! Competitive Pay! Bilingual required!! All candidates must [...]

Full Time RN

January 17th, 2019|0 Comments

Local Surgery Center looking for a full time Registered Nurse with at least 3 years experience! Must have valid RN license, CPR certification and BLS, ACLS! Monday - Friday! No weekends!! Competitive Pay! Bilingual required! [...]

  • Swollen Feet

Amputation Is Preventable

August 10th, 2016|0 Comments

Effecting 15 percent of patients with diabetes, a foot ulcer is an open sore or wound commonly found on the bottom of the foot. Anyone who has diabetes can develop a foot ulcer, and approximately [...]

Treatments for PAD

July 13th, 2016|0 Comments

Peripheral arterial disease, P.A.D., is a condition in which your arteries become clogged due to a buildup of extra cholesterol and fat. Normally seen in the lower limbs, P.A.D. can be seen anywhere in the [...]