Patient Forms
hank you for selecting Audubon Orthotic & Prosthetic Services in Colorado Springs for your orthotic or prosthetic care. To schedule an appointment at our Briargate office, please call us at (719) 867-7335. For our Lake Plaza Drive office, call (719) 622-4578.
Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.
Downloadable Forms:
- Patient Registration
- Medical History
- Satisfaction Survey
- Financial Agreement
- Authorization for Release of Records
- HIPAA Policy
- Patient Bill of Rights
- Medicare Supplier Standards
- Service Warranty
- Return Agreement
Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.
What to Expect
We take the guesswork out of the orthotic and prosthetic process. Our deep level of engagement with our patients enables us to help you understand what to expect when you receive an orthosis or prosthesis.
Patient Testimonials
Since 2000, Audubon Orthotic & Prosthetic Services has helped hundreds of patients overcome trauma or the loss of a limb with custom-fitted orthotics and prosthetics. We love hearing their stories of courage and triumph.
