Dermatologist in Colorado Springs, CO.

New Patients Form Packet

To minimize all our patient's unnecessary wait time due to required paperwork, please fill out the forms below by choosing the secure Online format at least 24 to 48 hours before your visit so we can expedite the check-in process for your appointment.

If you cannot complete your patient forms before your appointment, please plan to arrive at least 15 minutes early. Please be aware all New Patients must complete all four forms before the patient is officially checked in and ready for the provider. Failure to complete forms on time could result in the need to reschedule your appointment.

Existing Patients are not required to fill out the forms below unless otherwise informed during scheduling your visit.

New Patient Forms

Complete ALL four forms below:

Formularios en Español

Complete los cuatro formularios:

  • Política Financiera [PDF]
  • HIPAA (Español) [PDF]
  • Historia Clínica [PDF]
  • Información del Paciente [PDF]
  • Autorización del paciente para el uso o divulgación de información médica protegida [PDF]

Patient Policy Forms

Formularios de Póliza del Paciente

  • Formularios de póliza del paciente [PDF]

Get Adobe Reader In order to view or print these forms you will need Adobe Acrobat Reader installed.  Click here to download it.

Our Locations

Hours of Operation

Closed for lunch from 12:00 PM - 1:00 PM

Colorado Springs Location

Monday

7:30 am - 5:00 pm

Tuesday

7:30 am - 5:00 pm

Wednesday

7:30 am - 5:00 pm

Thursday

7:30 am - 5:00 pm

Friday

8:00 am - 4:00 pm

Saturday

Closed

Sunday

Closed

Trinidad Location

Monday

Closed

Tuesday

Closed

Wednesday

Closed

Thursday

Closed

Friday

8:00 am - 4:30 pm

Saturday

Closed

Sunday

Closed

Pueblo Location

Monday

8:00 am - 5:00 pm

Tuesday

8:00 am - 5:00 pm

Wednesday

8:00 am - 5:00 pm

Thursday

8:00 am - 5:00 pm

Friday

Occasional

Saturday

Closed

Sunday

Closed

Colorado Springs Location

Monday
7:30 am - 5:00 pm
Tuesday
7:30 am - 5:00 pm
Wednesday
7:30 am - 5:00 pm
Thursday
7:30 am - 5:00 pm
Friday
8:00 am - 4:00 pm
Saturday
Closed
Sunday
Closed

Trinidad Location

Monday
Closed
Tuesday
Closed
Wednesday
Closed
Thursday
Closed
Friday
8:00 am - 4:30 pm
Saturday
Closed
Sunday
Closed

Pueblo Location

Monday
8:00 am - 5:00 pm
Tuesday
8:00 am - 5:00 pm
Wednesday
8:00 am - 5:00 pm
Thursday
8:00 am - 5:00 pm
Friday
Occasional
Saturday
Closed
Sunday
Closed