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Patient Forms

Download and complete patient forms before your visit to save time at check-in.

Prepare For Your Visit

Complete Your Forms Before You Arrive

New patients should complete the required forms before their first appointment. Depending on your care needs, our team may ask you to complete additional forms.

Required Forms

New patients should complete all required forms before their first appointment.

New Patient Registration Form

Complete this form if you are a new patient to Peak Heart & Vascular. Includes personal information, emergency contacts, and insurance details.

PDF - 123 KB

PDFOnline

Health History

Detailed health history including past procedures, current medications, allergies, and family health background.

PDF - 116 KB

PDFOnline

Consent to Text Messaging

Authorize Peak Heart & Vascular to contact you by text message about appointments and your care. Review and sign to opt in.

PDF - 141 KB

PDF

Notice of Privacy Practices Patient Acknowledgement

Acknowledgement form confirming you have received and understand our privacy practices.

PDF - 86 KB

PDFOnline

Additional Forms

These forms may be needed depending on your visit type or circumstances.

Medical Records Release

Authorization to release your medical records to or from another healthcare provider.

PDF - 121 KB

PDFOnline

Notice of Privacy Practices

Information about how your protected health information may be used and disclosed.

PDF - 163 KB

PDF

Instructions

  1. 1Download and print the required forms
  2. 2Fill out all sections completely and accurately
  3. 3Bring your completed forms to your appointment
  4. 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 or Text 602-698-7325

Take The Next Step

Your Journey To Better Cardiovascular Health Starts Here

Whether you're experiencing symptoms, managing an existing condition, or taking a proactive approach to your cardiovascular health, our team is here to guide you every step of the way.

Schedule AppointmentCall or Text 602-698-7325