Patient Information - The RANE Center for Venous and Lymphatic Diseases at St. Dominic\'s :: Vascular & Endovascular Surgery :: Seshadri Raju, M.D., F.A.C.S., Vascular Surgeon

We welcome you to our offices. Before you come in for your first appointment, we need you to download, print and fill out these three forms.

» Step One

First, please click the following link to download the Patient Arbitration Agreement:

Download Patient Arbitration Agreement (PDF)

Once downloaded, please print so that you can bring it to the appointment. Please read the contents, though it will be explained to you in the office before you sign it.

» Step Two

Second, please click the following link to download the Patient Information Form:

Download “Patient Information” (PDF)

Once you download this, please print and fill it out so that we can know more about you.

» Step Three

Lastly, please download the “Quality Of Life” Questionnaire:

“Download Quality of Life Questionaire”

Once you download this, please print and fill it out so that we can know more about you. This form will need to be done prior to your exam.