
Please print these forms, fill them out as completely as possible, and bring the
originals with you the day of your appointment. Completing these forms before
your appointment will assist us with getting you seen by your care provider
more quickly.
New Patient Forms
Patient Responsibilities Regarding Insurance
Personal Health History
Red Rocks Release Records To Us
To All Our Medicare Patients:
This is to inform you of certain things that Medicare may not pay for. You need to have this information to make an informed decision about whether you wish to have these services. There may be other things that are recommended that Medicare may not cover and we will do our best to inform you of these services should they be recommended. Please feel free to discuss this with our office if you have any questions. We are required to have you sign this form and to keep a copy of it in your chart.
Advance Beneficiary Notice of Noncoverage (ABN)
Instructions for printing forms:
1. Make sure you have Adobe Acrobat Reader installed on your computer.
You will need this to be able to view and print the forms. You can download
Acrobat Reader to you computer by clicking on the Adobe Reader icon below. This
software is free to use for an unlimited amount of time. Many companies publish
books, manuals, etc. using Adobe Acrobat, so you will most likely be able to
use this software again for other purposes.
2. Click on the hyperlink above to be directed to the form you want to
print.
3. Click on the "Open" button.
4. You will see the Adobe Acrobat splash screen before your form opens.
Depending on the speed of your Internet connection, it may take several moments
for the form to come up.
5. When the form opens, click on the "Print" icon just above the form.
6. Select the printer you want to use from the drop down list if you have
more than one printer.
7. The rest of the selections should be OK, so click on the "OK" button
to print out the forms.
8. Bring the completed forms with you to your appointment.
You
will need Adobe Acrobat Reader to view and print these forms. Please click here
if you need to download Acrobat Reader.
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