Forms

Please bring these forms to your first appointment. They can be downloaded, completed and printed:

Medical History
Patient Information Form

Other Information:

Patients' Rights
Notice of Privacy Practices
Imaging Checklist

Our Mission

NCTVI provides expert
diagnosis and personalized
treatment plans for
patients with vascular
conditions.

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Locations

Northern California Thoracic
and Vascular Institute Clinic

5 Medical Plaza, Suite 140
Roseville, CA 95661

Phone (916) 783-8114

Fax (916) 783-8166

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Capitol Imaging
IR Department

3161 L St., Lower Level
Sacramento, CA 95816

Phone (916) 732-7777

Fax (916) 450-2050

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Roseville
Imaging IR Department

1640 E. Parkway Suite 100
Roseville, CA 95661

Phone (916) 732-7777

Fax (916) 453-5735

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Interventional
Neuroradiology Clinic

2801 K Street, Suite 240
Sacramento, CA 95816

Phone (916) 925-9526

Fax (916) 925-9515

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Interventional Radiology
Consultation Office

5 Medical Plaza Dr., #140
Roseville, CA 95661

Phone (916) 732-7777

Fax (916) 450-2050

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RAS Vascular Imaging

3161 L St. (Lower Level)
Sacramento, CA 95816

Phone (916) 453-9999

Fax (916) 456-3590

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