Patient Forms
Download and complete these forms before your visit to save time at check-in.
Required Forms
New patients should complete all required forms before their first appointment.
New Patient Registration Form
RequiredComplete this form if you are a new patient to Peak Heart & Vascular. Includes personal information, emergency contacts, and insurance details.
PDF - 245 KB
Health History
RequiredDetailed health history including past procedures, current medications, allergies, and family health background.
PDF - 312 KB
Medical Records Release
RequiredAuthorization to release your medical records to or from another healthcare provider.
PDF - 142 KB
Notice of Privacy Practices Patient Acknowledgement
RequiredAcknowledgement form confirming you have received and understand our privacy practices.
PDF - 156 KB
Additional Forms
These forms may be needed depending on your visit type or circumstances.
Notice of Privacy Practices
Information about how your protected health information may be used and disclosed.
PDF - 198 KB
Instructions
- 1Download and print the required forms
- 2Fill out all sections completely and accurately
- 3Bring your completed forms to your appointment
- 4Arrive 15 minutes early to allow time for check-in
What to Bring
- Photo ID (driver's license)
- Insurance card(s)
- List of current medications
- Referral (if required)
- Completed patient forms
Need Help?
If you have questions about which forms to complete or need assistance, please contact us.
Call 602-698-7325