Intake Forms

Welcome to Our Intake Forms Page

To help streamline your visit, Dakota Vascular now offers most intake forms as secure online forms that can be completed in advance of your appointment. Completing these forms ahead of time allows our team to review your information before you arrive and helps reduce paperwork during check-in.

Please review the sections below carefully to ensure you complete the correct forms.

How to Use These Forms

For Online Forms

1. Select the appropriate form below.
2. Complete all required fields online.
3. Submit the form electronically prior to your appointment.

For Print Forms

1. Download the form labeled “Print and bring in.”
2. Complete the form using black or blue ink.
3. Bring the completed form with you to your appointment.

Completing your forms in advance helps us provide efficient, timely care from the moment you arrive.

If you have questions or need assistance, please contact our office at 605-306-6100.

FOR PROVIDERS

• Patient Referral Form

Use this form to securely submit referrals to Dakota Vascular.

FOR PATIENTS

• Patient Demographic Form (Online submission)
• Release of Medical Information (Online submission)
• Annual Consent (Online submission)
• Medication Form (Print and bring in)