WARNING

You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]

Follow Us

Colorado Springs  719-520-3333

Falcon  719-495-6611

Windsor  970-460-0220

Patient Forms

To make the most of your time in our offices, please fill out this form in advance of your visit. All forms will be sent through a secure HIPAA compliant server.

Vision Insurance

Medical Insurance

Patient Medical History

Please indicate any following conditions with which you have been diagnosed.

Please indicate any eye conditions with which a family member has been diagnosed.