Please print, review and complete these patient forms before your appointment. You can fax the completed forms to Westminster Medical Center at (303) 487-5196 or bring them in with you to your visit.

 

New Patient Forms

 

Click on the following forms:

• Patient Information
• Notice of Privacy Practices
• Authorization to Disclose Health Information
• HIPAA notice and acknowledgement
• HIPAA Personal Designation Form
• Patient Medical Information
• Payment Terms and Agreements

 

Established Patient Forms

 

Each visit

• Office Visit Form– please complete this form prior to each visit so that we can best address all your concerns. Click here for the Patient Visit Agenda form.

 

Annually

• Physical Questionnaire –this form needs to be competed before your periodic health assessment or well-woman exam. Click here for the Health Assessment-Review of Systems
• Personal Information–this form needs to be updated once EVERY year. Click here for the Patient Information form.
•  Payment Terms and Agreements