This New Patient Medical History form will help you consolidate your medical history in preparation for your visit to our office. Please print the form and fill it out by hand. Please bring this form with you when visiting our office.
Note: Completing this form online WILL NOT retain any record of your personal information. It is designed solely for your convenience, to help utilize your time with us most productively. You will need to print a second copy if you want to keep a record of this information.
Your medical information is personal, and we are committed to protecting your confidentiality. We create a record of the care and services that you receive at Vascular Associates of San Diego, which allows us to provide you with quality care and to comply with certain legal requirements.