Patient
Registration Forms
Thank you for choosing Vascular Care Specialists of Los Angeles for your vascular healthcare. Please download, print, and complete the following forms before your first visit. Our front desk receptionist will collect them from you at check-in.
We look forward to meeting you.
Completed forms can be submitted via:
General Questions
You’ll need to complete the New Patient Registration Form, Medical History Form, Insurance Information Form, and the HIPAA Consent Form. These are available for download or online submission on this page.
Yes, you can complete the forms at our office. However, we recommend filling them out in advance to save time during your visit.
Absolutely. All patient forms submitted online or in person are handled in compliance with HIPAA regulations to ensure your information remains private and secure.
If you encounter any issues, please contact our office at (626) 275-9566 or info@vcsla.com, and we’ll assist you promptly.
Yes, please bring a valid photo ID, your insurance card, and a list of any medications you’re currently taking.
Additional Resources
At VCSLA, we’re committed to making your patient experience as seamless and informed as possible. In addition to completing your registration forms, we’ve compiled a list of helpful resources to ensure you’re fully prepared for your appointment and understand what to expect.
What Sets Us Apart
- Certified practitioners with extensive experience in Botox treatments for both medical and cosmetic purposes.
- Proven results backed by patient testimonials and a track record of successful outcomes.
- Personalized care to ensure treatments are tailored to your unique needs and goals.
