Patient Forms

New Patient

Form 116 (ROS)

Form 608 (Surgeries)

Form 899 (Pers/Fam History)

Follow Up Patients

Form 116 (ROS)

Patient Health History and Questionnaire

Endoscopy Patient Form

Anesthesia/Screening Patient Form

Anesthesia Consent Form

Patient Rights and Responsibilities

Financial Information

Medical Records Release

Endoscopy Center of Colorado Springs Financial Information

Procedure Forms

Colonoscopy Main Form

Cover Page

Halflytely Prep

NuLytely Prep


Miralax/Dulcolax Divided Dose Prep

2 Day Miralax/Suprep

Flexible Sigmoidoscopy Prep

Colon Prepopik Prep

Colon SuClear Prep

EGD Prep

Other Helpful Information

EGD General Instructions