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Patient & Physician Forms

For Patients

Please visit Our Services page to learn more about the care that our specialists provide. For additional details on vascular disease, read more through the Society for Vascular Surgery.

Our Notice of Privacy Practice describes how medical information about you may be used and disclosed and how you can access this medical information. Please review it carefully. Please also see our notice regarding the No Surprises Act.

All new patients with scheduled appointments need to fill out forms.

Patient Forms

Print forms to bring with you to your appointment.

Print our Medical Records Release Form.

Fill out and submit forms online
(please complete at least 24 hours prior to your scheduled appointment time)

For Referring Physicians

We are happy to collaborate with physicians in establishing treatment plans and providing comprehensive care.

The Vascular Care Group offers comprehensive expertise across all vascular and endovascular services. See our services page for a complete description of our capabilities.

Referring Physician Form

Download the referral form:


How can I obtain a copy of my medical records?

You may request your medical records by sending us an authorization allowing us to release your private health information. Please mail the authorization to the attention of Medical Records to the office where you will be seen. Please note that, by law, we may not release your medical information through a request made by phone or by e-mail.

The request should include your name, date of birth, and exactly what records you are requesting in order to process your request. Attorneys and Life Insurance Companies should contact our office for any questions about obtaining medical records.

How can I obtain a refill on my medication?

Most prescription refills should be managed by your primary care provider.

If you have any questions, you can speak to the receptionist in any of our offices to request a refill for your prescribed medications. Please request prescription refills during regular office hours so that we can contact your pharmacy during normal business hours. Please allow 24-48 hours for processing the request. Narcotics cannot be called in and will need a hard-copy prescription.

What if I need to cancel my appointment?

You may call the office at which your appointment was arranged. Please try and offer at least 24 hours’ notice of your cancellation so we can reschedule other patients appropriately.

Do I need a referral?

Every insurance plan is different. However, if you are unsure about whether a referral is required, you can contact your insurance carrier to confirm. Please ensure you obtain a referral in advance of your appointment if it is required by your insurance carrier. Please note that some referring physician offices require several days to process a referral, so please allow adequate time for this.

Our office would be happy to assist you with this process, just give us a call!

How can I make an appointment?

If you are a new patient, please use our online contact form to send a request for an appointment. You can also call one of our offices where you would like to be seen. If you receive a recorded message, please leave your name and a callback number, and we will return the call promptly.

What are your office hours?

We are available 24 hours a day, 7 days a week for emergencies.

Generally, our offices are open between 8:00am and 5:00pm. Current office hours may vary by location, so please contact the office where you would like to be seen to confirm.

Where are your offices located?

We currently have 10 locations, and we are actively expanding throughout New England. See our Locations page for details.

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We Accept Most Insurance Plans

It is always best to contact our office or your insurance company to verify before your visit, but it is very likely we accept your provider. You will be asked for your insurance card at each visit.

Are you satisfied with your care?

We hope that you are pleased with the care you have received from our offices. We try very hard to deliver the best care with compassion and respect. If you would like to share your experience with others, please visit the websites below and search for your physician.

What our customers are saying

“I would like to commend the entire staff I dealt with for their efficiency. Everyone from reception, nursing, and of course Dr. Simosawere very kind, pleasant, and knowledgeable. They took excellent care of me while I was there.”

“I was treated with the utmost respect during my surgery in the Worcester office. I was very happy with my follow-up appointment – a wonderful and warm experience with a staff full of class.”

“I was sincerely impressed with my experience. The attendants and nurses were extremely courteous and extremely professional…. Exceptional people and exceptional medical care.”

“I’m very pleased with the professional expertise of all staff that attended me. The Doctor was very attentive and personable and I am grateful she is part of a team who cares. I’m amazed that my bruising is almost non-existent.”

“I can say that every time has been the same. Staff and doctors were very kind and professional. I would recommend this company to anyone.”

“My experience has been excellent with Dr. Gorin and his team. The nurses are communicative, competent, and super friendly.”