Patient Forms

For your convenience, you can download, print, and complete the patient forms below before your visit to Colorado Springs Dermatology Clinic, P.C.:

Patient Forms (PDF)

New Patient Forms

New Patient.pdf

Notice of Privacy Practices.pdf

Medical History Form.pdf

Financial Policy and Authorization.pdf

Financial and Information Release.pdf

Other Forms

Medical Records Release Form.pdf

Telehealth Consent Form.pdf

Telehealth Visit Information Forms.pdf

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Patient Forms – Spanish (PDF)

Paciente Nuevo (New Patient).pdf

Poliza y Autorizacion Financiera (Financial Policy).pdf

Divulgacion de Informacion y Finanzas (Financial & Info Release).pdf