New Patient Forms
Welcome to RIA Endovascular! Thank you for putting your trust in our practice.
Please print and complete our new-patient forms prior to your first appointment at RIA Endovascular. Filling out your forms at home makes your appointment easier and faster for you, and assists us in serving all our patients efficiently. Likewise, we appreciate your on-time arrival!
If you cannot complete the forms prior to your appointment, please arrive 30 minutes before your appointment so you have adequate time to fill out the required forms. Thank you.
Below are our forms for new patients.
1) ALL new patients are requested to complete this set of forms:
2) If the primary reason for your first visit is related to one of the following, please complete this form as well.
Release Form for Obtaining Records
If you need a form to have records released to other providers or to yourself, use this Authorization to Use and-or Disclose Protected Health Information form.
We accept many forms of insurance. Visit our insurance page to see current coverage; be aware that this information is subject to change. Also, some insurance companies will occasionally contract with us for a specific specialized procedure(s) although there is no formal contract in place. This is up to your insurance provider; check with your insurance provider for details.
Billing is handled by our Patient Billing Department . Call 303.643.4500.
Please feel free to contact us at 720.493.3406.