To save you time and make your appointment efficient, we ask all our patients to come prepared for their appointment with completed paperwork. Find the forms that apply to you below, print, and complete them before you arrive at our office. You may still be asked for some information and signatures, but this will reduce the time spent on paperwork before your appointment. Please remember to bring your insurance card to each appointment and let us know if there are any changes to your coverage.
The Colorado Pelvic Floor & Incontinence center prioritizes the health and safety of each patient. We are committed to using the best clinical judgment for patient care. At times, our patients may experience urgent, time-sensitive, emergent issues. At these times, our providers must prioritize the emergent case over routine appointments. Our staff will do their best to accommodate you, either by rescheduling, helping you feel comfortable while you wait, or re-directing you to another provider in our office. We regret any inconvenience this may cause, but if you experience an urgent need, you will be happy to know our providers will make you the priority!
Are you new to our practice? If you have never seen our physicians before, please use the following forms:
Have you seen our doctors before? If you have records in our office, please use the following forms:
Records Release TO our office from another office:
Occasionally, we will ask you to authorize another physician’s office to provide us with your medical records. Due to privacy policies, you will need to request those documents with a form and your signature. The following form can be printed at home, completed and submitted to your outside physician’s office. This form grants them your permission to release your records to our office. They may ask you to hand-carry them to our office. In the event they mail or fax your records, please check with us to make sure the records have arrived in our office before your appointment.
Are you moving? Is your insurance changing preferred providers for you? Is another specialty needing your records? Please call the office you normally go to and request the appropriate forms, find out fees, and discuss processing time needed to complete your record transfer.
Thornton Office: Phone: 303-280-2229 / Fax: 303-280-0765
For your convenience, we have provided links to several of the major insurance companies so you can easily check your benefits and claim status. The Colorado Pelvic Floor and Incontinence Center participates with many other insurances that are not listed below. Please call us so we can discuss your particular insurance concerns. You can reach the billing department by telephone at 303-280-2229, or by emailing a note to firstname.lastname@example.org . Thank you!
Due to a decrease in COVID-19 cases in Colorado, we have updated our visitor policy to allow one masked visitor per patient. All patients and visitors must wear a face covering.