340 Printers Parkway

Colorado Springs, CO 80910

 

Customer Service Center:

719-632-5700

 

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If you are having a life threatening emergency, please call 911 immediately.


This form is to be filled out only by registered members* for routine medical visits and requested at least 3 days in advance. For same day appointments for members, please call 632-5700.

*All homeless patient visits must be made by contacting our Homeless Health Center at 471-2789 or walking in at 117 W. Rio Grande St.

 

If you have not registered as a patient, please click here to register now.

 

 

 

 
Please fill in all fields marked with a *
First Name (*required) * Required
Last Name (*required) * Required
Contact Name
Street Address
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Daytime Phone and Extension *Required
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Reason for Visit (*required) *

Please choose the days and times that would work best for you or choose a date that best fits your schedule.

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