Patient Forms

Please arrive to the clinic at least 30 minutes prior to your scheduled appointment. This is extremely important as you will need to sign additional forms and we will need to make a copy of your insurance card.

Please print the following pertinent forms, fill them out and return them to our clinic at your appointment or you may also fax them to us at 719-955-9595.

New Cough Center Patient Packet:
Information and forms for new patients at our Cough Center.
Download New Cough Center Patient Packet

Insurance & Yearly Update Form:
Must be filled out for change of insurance and yearly updates.
Download Insurance & Yearly Update Form

Medical History Release Form:
Authorization to Receive or Release Medical Records.
Download Medical History Release Form