patient forms  Fort Collins, CO

The online intake is preferred, but we understand sometimes computers don’t do what we want them to.   Please complete this online form on a laptop or desktop computer (the form will not transmit when completed on a mobile device).

Tips for completing online form:

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • You do not need to complete every entry on the form.  If something does not apply, simply skip that and go to the next question.  (After signing, it may say “fields are incomplete”, but it will transmit okay!)
  • When finished, sign your name using your mouse, click “submit” and the data will be securely transferred to our system.
  • If you’re unable to complete the online version, or prefer paper, please choose the appropriate intake form below, print it out, and fax it to us (970 206 4871) or bring it to your appointment. Your other choice is to come 15 minutes early to your appointment to fill out the intake form in the office.

Auto Accident Form  If you were in an auto accident, kindly print this form and bring it in with your visit instead of completing the online intake form.  (You will need Adobe Acrobat Reader installed to access the paperwork.  Click Here to Download Adobe Acrobat Reader for Free.)

Kids Ages 0-3 Form

Kids Ages 4-8 Form

Kids Ages 9-13 Form

Kids Ages 14-17 Form

Patient Privacy Policy