Contact Us


Facebook


Facebook


Vimeo


Youtube


Icon-google-review

Book Your Appointment

[gravityform id=”1″ title=”true”]

Intake Forms

Please print, fill out and bring with you on the first visit:



Patient Registration Form


Download PDF



Patient Registration Form (Spanish version)


Download PDF



Health Questionarre


Download PDF

HIPAA Form


Download PDF



Insurance Information and Financial Policy Form


Download PDF



NOTICE AND ACKNOWLEDGMENT OF RECEIPT AND UNDERSTANDING


Download PDF



California Vascular & Vein Center Spanish Version


Download PDF



AUTHORIZATION TO RELEASE HEALTHCARE INFORMATION


Download PDF

Address

177 E Houston St
New York, NY 10002

Phone

+(888) 695-9859
+(888) 569-9859

Email

info@example.com
hello@example.com

Book Your Appointment

[wpforms id=”10″]

Milpitas02

995 Montague Expy 213, 2nd floor Milpitas, CA 95035
Tel: (408) 708-4153
Fax No : 408-889-6150

Hours:

Monday to Wednesday:
9 AM to 4 pm

Bakersfield 01

2808 F Street, Suite A
Bakersfield, CA 93301
Tel: (661) 873-4216
Fax: 661-873-4216

Hours:

8 am to 4 pm weekdays
8 am to 1 pm on Saturdays
Sunday closed

Expert Care for Healthy Legs

$100 OFF on All Vascular Service



Book An Appointment Now