Forms

New Patient Paperwork

To become a new patient, please pick up a paperwork packet from our office or print from the link below. Return the completed forms to the office at your convenience. We will then request your medical records from your previous provider. After reviewing your case, a provider will contact you to schedule you first appointment, which we prefer to arrange after we have received your medical records to ensure a more productive consultation. We look forward to meeting you!

Office Policies

Check out our office policies!

HIPAA

Complete this form to specify the individuals permitted to obtain your health information.

Colorado Advanced Directives

Complete this form to outline your preferences for medical care in the event that you are unable to communicate your wishes.  

Annual Exam Paperwork

Complete this paperwork and bring it to your scheduled Annual Exam appointment. Note: Failure to complete the paperwork before your scheduled appointment may result in rescheduling your appointment with a fee. This annual paperwork is required by insurance. 

Patient Information

Complete this form if you need to update your patient information including contact and insurance information.

           INTERNAL MEDICINE & AESTHETICS OF THE ROCKIES             
2875 INTERNATIONAL CIRCLE, COLORADO SPRINGS, CO 80910
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