Payment Agreement

All payments are due by the 25th of each month (if the 25th falls on a Saturday or Sunday the payment will be due the Friday BEFORE the 25th.) If payment is not received by the 25th, Colorado Springs Gynecology Associates reserves the right to collect full balance and void prepay agreement. If patient account becomes one (1) payment in arrears, the full balance on the above patient account becomes due immediately. Balances on ninety (90) days old will be referred to a collection agency at the discretion of Colorado Springs Gynecology Associates.


Please download and fill-out our payment agreement form, and bring it with you to our office on your first visit.

Technical Note:

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