On Your First Visit

What you need to know for your first visit.
Thank you for choosing LA Vascular. We welcome you as our patient. Prior to your first visit, please complete the new patient forms and review the information below. To save time at your first visit bring in your forms completed. If you have any questions, please contact us.

• Print out and fill in the below 3 forms to bring with you to your appointment.
• A list of all the medications you are currently taking
• Include the dosage and frequency found on the Rx label
• Please list non-prescription medicines and supplements as well
• The name and phone number of your primary care doctor.
• The name and phone number of your referring doctor (if different from your PCP) and a copy of your referral.
• Any lab results or X-ray films provided by your referring doctor
• Valid Drivers License
• Health insurance card(s) or other information about your health coverage
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Patient Information Sheet (PDF)

Patient Information Sheet (PDF)

Acknowledgement of Receipt of Privacy Notice (PDF)

Acknowledgement of Receipt of Privacy Notice (PDF)

On Your First Visit
Patient Feedback Form