Home | About Us | Contact Us

For Patients
Referring Physicians
Our Physicians
Areas of Expertise
Locations
Today is Wednesday, June 19, 2013
Today's date:
Wednesday
June 19, 2013
Wednesday, June 19, 2013
06/19/2013
Wednesday
06/19/2013
June 19, 2013
June 19
19-Jun-2013
Login

Locations

Hartford Location
1000 Asylum Ave
Suite 2120
Hartford, CT 06105
tel: 860-246-4000
fax: 860-527-6985

map this location »

Bloomfield Location
1 Northwestern Drive
Suite 302
Bloomfield, CT 06002
tel: 860-246-4000
fax: 860-527-6985

map this location »

Learn more about Varicose Vein Therapy



Medical News
IAC_VascularTesting.jpg


For Patients


For New Patients

These forms will help prepare for your visit to our office. Please print them, fill them out, and bring them with you when visiting our office.


All new patients, please fill out the Patient Registration Form and complete the HIPAA Privacy Notice:

For non-varicose vein patients, please fill out the Patient History Form:

For varicose vein patients, please fill out the Varicose Vein Patient Registration and Medical History Forms:

Pre-Procedure Instructions

Discharge Instructions

Click on the subject below to view the instructions.

Varicose Vein Procedures:

Aortic procedures:

Other procedures:

Notice of Privacy Practices

This notice of Privacy practices ("Notice") describes how we may use and disclose your health/medical information and how you can get access to this information.


Adobe Acrobat Reader needed to view forms. Adobe Acrobat




Terms and Conditions | Feedback | Privacy Statement
Developed and hosted by Vascular Domain.
© Copyright 2000-2013. NorthPoint Domain Inc. All rights reserved.
ICS-PR-WEB02