Spine Colorado - Patient Pre-Registration Forms

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One Mercado Street, Suite 200 Durango, CO 81301
Phone: 970.382.9500
Toll Free: 800.524.9821
Fax: 970.259.6045

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Patient Pre-Registration Forms

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If you have an appointment in our office and would like to complete your registration process, please print the following form(s). These can be mailed to us if time allows, or you may bring them with you at the time of your appointment.

If you are a new patient please complete both a registration and health history form.

Registration form

Health History form for Dr. Gwendolyn Grant

Health History form for all other physicians

We would also appreciate your time to complete one of the following forms, which will tell us about your injury or symptom:

Back or neck injury or symptom (2 pages)

Shoulder injury or symptom (2 pages)

Knee injury or symptom (2 pages)

Other injury or symptom (hand, wrist, arm, elbow, hip, leg) (1 page)

If time allows, mail the completed forms to the following address:

Durango Orthopedic Associates
Attention: Medical Records
1 Mercado Street Suite 202
Durango, CO 81301

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Need more information on back and neck pain?
Click here to view resource books on spine problems, what causes back pain, what causes neck pain and when to see the doctor.