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GET A HEAD START ON YOUR APPOINTMENT
  • If this is your first visit with us, we will ask you to complete our registration and health history forms. We have provided these forms through this website so that you can complete them at home where you have full access to your prescriptions, family and health history information. It is essential to et this paperwork back to us prior to your appointment. This allows us time to load it into our electronic medical record system. If you cannot get it back to us before the appointment please show up 30 minutes ahead of your appointment to allow us to load your information. If you have any questions about these forms or your appointment, please contact our office @ (719) 634-1994. Click below to view and print our new patient registration and medical history forms.
INSURANCE CARD
  • Please bring your insurance card. We will need to copy your card. There is very important information on the front and back of this card. If we do not get the information it may be necessary for us to bill you for the services provided.
REFERRAL
  • Some insurance companies require that you obtain a referral from your insurance company. This referral should be initiated by your primary care physician.It is important to intiate the process several weeks in advance of your appointment. You should receive a copy of the approved referral in the mail. It is a document that provides a referral number, number of visits authorized and an expiration date. We will notify you via telephone if we do not have a copy of this document. You will be directed to contact your primary care physician to request that a copy be faxed to (719) 634-2906.
TEST RESULTS
  • If you have had a CT scan, IVP , PSA or other tests related to your current medical symptoms, please bring those results and the films to your appointment. If you are coming in to visit with your doctor to discuss the results of a recent PSA, please contact the facility where the blood was drawn and request that the results be faxed to us at (719)634-2906.

Print out the following forms for your convenience...
New Patient Information
 		Fill this form out prior to your arrival at our offices and save time in the waiting room.
Vasectomy Packet
 		Fill out this form if Urological Associates will be performing your vasectomy.

 

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