VALLEY INFECTIOUS DISEASE ASSOCIATES

Comprehensive infectious disease care for adults and children

14901 National Ave., Ste. 202

Los Gatos, CA 95032

(408) 374-5340

M - Th

Friday

9:00am – 5:00pm

9:00am – 12:00pm

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    Registration forms

    We request that new patients download and fill out forms beforehand to ensure faster service
    ID clinic registration forms
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    • New patient registration form

    • HIPPA Form

    • Acknowledgment of Receipt of Notice of Privacy Practices Form

    Travel clinic registration forms
    • Patient Registration Form

    • Patient Registration for Haitian volunteers

    • Patient Medical History Form

    • Travel Medicine Clinic HIPPA Form

    • TB Test and Form

    • Acknowledgment of Receipt of Notice of Privacy Practices Form

    Valley Infectious Disease Associates

    14901 National Ave., Suite 202

    Los Gatos, CA 95032

    For Life-Threatening Emergencies Call 911
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    © 2018 Valley Infectious Disease Associates