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New Patients
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If you are a new patient, or have not been to our office in the past 3
years, please print out, complete, and bring all of the following forms with
you to your appointment. Completing these forms before your
appointment will assist us with getting you seen by your care provider
more quickly.
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Personal
History Form
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Confidential Information Sheet
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Privacy Practices Attestation Form
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Financial Policy
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Patient
Responsibilities Regarding Insurance
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Release of Medical Records
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If you need to transfer any pre-existing records from another
practice/facility to our office, please print out and complete this
form. You may bring this form with you to your appointment or fax
this form prior to this appointment.
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Release of
Medical Records TO Red Rocks OB/GYN
If you need us to transfer your medical records to another provider, please download and fill out this form.
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Release of
Medical Records FROM Red Rocks OB/GYN
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Medicare Patients
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This is to inform you that there are certain
services that are not covered by Medicare. You need to have know
this information in order to make an informed decision about whether you
wish to have these services. There may be other recommended
services 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 at 303-763-5111.
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HIPAA Policy |
Please read the document below to review how the HIPAA policy affects
the use and disclosure of your personal health information.
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HIPAA Notice of Privacy Practices
Please download and sign the document below acknowledging that you have read the HIPPA Notice of Privacy Practices.
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HIPAA Notice of Privacy Practices Acknowledgement
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You will need Microsoft Word to view and print these forms.
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