PATIENT FORMS

 

We look forward to seeing you at ELITE VISION. To save time on the date of your appointment we kindly request that you complete both the NEW PATIENT FORM and the INSURANCE AUTHORIZATION forms and bring them with you to your appointment. Both of these forms are located below and can be printed and completed.  Additionally, our NOTICE OF PRIVACY PRACTICES is below for your reference.

 

We value your privacy and respect all components of the HIPPA Privacy Act. If you elect not to complete these two forms in advance, we ask that you arrive 10-15 minutes prior to your appointment to complete these forms. Thank you in advance for your understanding, we value your time and want to make this process as efficient as possible.

ELITE VISION

4195 Centennial Blvd. 
Colorado Springs, CO 80907
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(719) 471-1107
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Monday - Friday:  8:30am - 6pm

             Saturday:  9am - 2pm

© 2020 ELITE VISION