Phone: 203.288.2886 / Fax: 203.288.2576

Required Forms

If this is your first visit to Connecticut Vascular Center you will need to provide information that will enable us to register you in our electronic medical record. In order to reduce the amount of time you will spend in the office doing paperwork we ask that you download the forms listed below, complete them at home, and bring the completed forms with you to your visit along with the following:
  • Insurance card(s)
  • Photo i.d. (drivers license, passport, state i.d., Green card)
  • A referral from your primary md if required
  • Your co-payment if you have one
  • Any test reports/films/cd