Couchman Center for Complete Dentistry
Creating Beautiful Smiles
Call: (719) 593-0263

Patient Forms

If you are a new patient to our office, you may complete the patient forms when you arrive at our office or you could print them out, complete them and bring them with you to your appointment. This will allow us to attend to your medical needs more quickly than completing them on your arrival. Please let us know if you have any questions. 

Patient Forms

Health History Form

HIPPA Consent Form

Financial Policy Form

Filing Your Dental Insurance Form


View More