NEW PATIENT REGISTRATION FORMS
Thank you for choosing Hill Vascular & Vein Center for your vascular healthcare. Please download, print, and fill out 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.
New Patient FormsACCEPTED INSURANCES
Our list of accepted insurance carriers gets longer each week. Please call 408-770-HILL (4455) during regular business hours to inquire about your insurance plan, or click below to inquire via email.
ACCEPTED INSURANCESAUTHORIZATION FOR MEDICAL RECORDS RELEASE
If you are in need of obtaining your medical records for transfer to Hill Vascular & Vein Center, please download this form, complete, and either email or fax it to the office who currently holds your records.
MEDICAL RELEASE FORMPHYSICIAN REFERRALS
At Hill Vascular & Vein Center, we value collaboration and teamwork with other physicians. If you would like to refer a patient to our team, please download our Physician Referral Form and fax it to 408-770-4770. We appreciate your trust in us and look forward to working with your patient towards better vascular health.
REFERRAL FORM