Registration Information

Patient registration is an important process that helps set everything in motion for submitting claims to your insurance company and to help insure that the information we have is correct to help limit billing confusion and make your visit with us as pleasant as possible. Please make sure that you have the following information when you come in for your visit.

If you have any questions please don’t hesitate to call us at (719) 632-4455.

Complete and bring in new patient information to help limit your wait.

  • Adult New Patient Packet  – New patient registration, consent and medical history for adults
  • Pediatric New Patient Packet  – New patient registration and consent for children/minors
  • Bring in Photo ID
  • Bring in your patients current health insurance card
  • Previous Medical Records if necessary
  • Be prepared to pay co-pay

Patient Forms

Click below find all of our printable forms. If you have any questions please don’t hesitate to call.

Patient Forms Page

 

Exceptional Healthcare for Children and Adults

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