Patient Information, Forms, Resources
Patient Registration Forms: For new patients and patients wishing to update their current information.
Patient Registration Form
Please complete any applicable form and submit to: email@example.com.
To request a copy of our Financial Policy and/or Notices of Privacy Practices please email a request to: firstname.lastname@example.org
Release of Records
Health Information Sharing Release of Information
Colorado Immunization Registry: Our office participates in the Colorado Immunization Information System (CIIS) immunization registry. For details including the CDPHE Immunization Registry Notice and Opt-Out Options please see the links below.
Colorado Immunization Registry Notice
Colorado Immunization Registry Opt Out Form-English
Colorado Immunization Registry Opt Out Form-Spanish
Please follow the instructions on the forms-do not return these forms to Steamboat Springs Family Medicine.
For complete information on CIIS Opt-Out, Rescind Op-Out Procedures and forms in additional languages: https://cdphe.colorado.gov/ciis-opt-out-procedures
VIIS (Vaccine Information Statements) and Vaccine Schedules
For copies of the most up to date vaccine information sheets please visit https://www.cdc.gov/vaccines/hcp/vis/current-vis.html
For CDC recommended immunizations schedules please visit: https://www.cdc.gov/vaccines/schedules/
We know you have many options when choosing a doctor in Steamboat Springs and we can assure you that our providers and staff will provide you with an exceptional level of service and high quality medical care. The personalized preventive medicine model we practice allows us to provide unhurried, individualized, and convenient health care to each and every patient in our practice. To learn more about our practice model and how it can benefit you, please call our office to schedule your complimentary “Meet and Greet” visit.
Insurance and Billing
Please contact our office to verify acceptance of your plan. Qualifications for insurance coverage may differ due to the uniqueness of each procedure. All patients are responsible for their visit co-payments.
- Blue Cross Blue Shield
- Child Health Plan Plus – CHP
- Cofinity (formerly Sloans Lake)
- Great West
- Railroad Medicare
- Rocky Mountain Health Plan
- United Health Care
HMO: Please be aware that HMO plans will most likely not be covered. If you have an HMO plan it is your responsibility to contact your insurance company to see what, if anything, needs to be done to get a visit preauthorized. Look on the back of your insurance card for the phone number.
Out of Country: We do not bill out of the country insurance companies. You will need to pay up front and we will gladly give you a receipt so you can submit the charges yourself.
Co-pay: If you have a co-pay we expect payment for that at time of service.
Deductible: If you know you have a deductible, please be prepared to pay at time of service.
Payment Plans: We are happy to work with you in setting up a payment plan. However, please be prepared to pay something at the time of service and make sure you make consistent payments.
We have a patient portal where you can securely access selected health information and communicate with our providers and staff. Please contact our staff if you are interested in being registered for the patient portal. Once one of our staff members have registered you, click here for instructions on completing the process. If you have any questions, please let us know.