If you need a more accessible version of this website, click this button on the right. Switch to Accessible Site

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.