Email Collection Form

To add or update the email address you have on file with Boulder Community Health, you must submit an Email Collection Form to the Medical Records Department. Click here to download and print a form.

You can submit your completed form in the following ways:

1. By mail. Complete the form and mail to:

Medical Records Department
Boulder Community Health
P.O. Box 9047
Boulder, CO  80301-9019

2. In person. Complete this form and bring it to the Medical Records Department, located on the Foothills Medical Campus in the Tebo Family Medical Building, located at 4747 Arapahoe, Suite G30, Boulder.

3. By fax. Complete this form and fax it to 720-854-7763.

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