Registration Information

Registration Information

Patient registration is an important process that helps set everything in motion for submitting claims to your insurance company and to help ensure 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(opens in a new tab)  – New patient registration and consent for children/minors
• Bring in Photo ID & health insurance card
• Previous Medical Records if necessary
• Be prepared to pay co-pay

COVID-19 Vaccine Scheduling ONLY

• Please complete and submit the registration form.
  • COVID-19 Vaccination Registration Form
• A staff member will review your registration and contact you with a date/time.

Patient Forms

Click below to 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