Patients

Please remember to bring your driver's license or a valid form of I.D., your insurance card, and a form of payment for your copay.

New Patient Forms

Print these forms and fill them out to save you time in the office. For your convenience they are available for download in Adobe PDF or Microsoft Word format.

Financial Policy (doc)Download

Financial Policy (pdf)Download

Patient Registration (doc)Download

Patient Registration (pdf)Download

Patient Responsibility & Communication Consent (doc)Download

Patient Responsibility & Communication Consent (pdf)Download

Medical History (doc)Download

Medical History (pdf)Download

Notice of Privacy Practices for Protected Health Information (pdf)Download

Notice of Privacy Practices for Protected Health Information (rtf)Download

North Springs Surgical Associates, P.C.

6071 East Woodmen Road, STE 340, Colorado Springs, Colorado 80923

719-591-8100 719-591-8101 Fax

Hours

Mon	08:00 am – 05:00 pm
Tue	08:00 am – 05:00 pm
Wed	08:00 am – 05:00 pm
Thu	08:00 am – 05:00 pm
Fri	08:00 am – 04:00 pm
Sat	Closed
Sun	Closed

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