Call us toll free at 877.597.7979 to make
an appointment for your initial consultation.
Contact Us
  1. (required)
  2. (required)
  3. (valid email required)
  4. (required)
  6. Captcha
 

cforms contact form by delicious:days

Patient Forms

New patient?

Save time by using this page to download patient forms that you can fill out and bring to the office before your initial consultation. If you have any questions please feel free to call us at 719.597.7979 and we would be happy to assist you. The forms are in Adobe Acrobat reader. If you do not have the software installed on your computer you can get it free by clicking here.

Click on a link below to download the form.

pdf iconNew Patient Intake Form

pdf iconNotice of Privacy Practices

pdf iconAcknowledgement of Receipt of Privacy Practices

pdf iconPatient Questionnaire

pdf iconConsent Form

pdf iconMedical History

pdf iconPayment Policy

pdf iconHow Did You Find Our Office

pdf iconDental Operatory Policy

pdf iconFailed Appointment Policy