|
The Boulder Center for Sports Medicine wants to help you expedite the check-in process at our front desk. Thank you for taking the time to do this before your scheduled visit. The following paperwork can be printed and completed prior to your visit. Physical Therapy, Physicians Clinic, and Sport Science Patients Medical History Form (pdf)
Medication List (pdf)
Financial Policy (pdf) Medicare Patients Only (print these in addition to the above) Medical Necessity Survey (pdf) Secondary Payor Information (pdf) Optimal Outcome Instrument (pdf) Sports Physicals (print this form in addition to the above) Sports Physical Survey (pdf) Nutrition Clients 3-Day Diet Record Additional Information (does not need to be filled out, only reviewed) HIPAA Privacy Act (pdf) Patient's Rights & Responsibilities (pdf) Medical Records (If you would like to request a copy of your medical records, you will need to sign a release form) Medical Records Release Form (pdf)
|