Pechek Dental Forms

We offer three easy solutions for completing your new patient paperwork.


- Securely complete your forms online before your appointment
- Print and complete your forms to bring with you to the appointment
- Plan to arrive 15 minutes before your scheduled appointment to complete your paperwork at the office

We are not a Medicaid provider. We do not accept it as primary or secondary insurance.

Please select what you would like to do below:




Patient Information Form

HIPAA Consent Form

Contact

If you ever need to reach us or have any questions or concerns about your visit, our staff is ready to assist. Please contact us at your preferred method below.

Location:

24 Club Manor Dr. #202
Pueblo, CO 81008

Call:

(719) 766-9020

Hours of Operation:

Mon, Tue, Thurs - 8:00am-5:00pm

Wed & Fri - 8:00am-2:00pm