Patient Forms

MEDICAL RECORDS REQUEST

Send Records TO Foothills

Request Records FROM Foothills
This form is for sending records from our office. Please mail or fax this signed form to our office, along with a copy of your Drivers License or other government-issued Photo ID (passport, state ID card, etc.) Please note that in accordance with Colorado State law, a fee may be charged to process this request.

IMPORTANT INFORMATION

Notice of Privacy Practices

Insurance & Billing Information

Patient Rights & Responsibilities Brochure