Thank you for choosing Boulder Community Health for your outpatient rehabilitation
needs. We look forward to partnering with you to help you achieve your
Prepare for Your First Visit (Evaluation)
Download, print and complete the appropriate forms. (Forms require Adobe Reader:
Free download of Adobe Reader)
- Bring forms with you to your first appointment.
- Bring your physician's prescription/referral if required by your insurance.
- Bring your health insurance card, photo identification, form of payment
and a list of current medications.
- Wear comfortable clothing.
- Plan to check in 15 minutes prior to your evaluation time.
- At the Boulder location, please allow additional time to get from the parking
lot to the check in desk on the 2nd floor. (Enter through the hospital's
main entrance on Balsam Avenue. Wheelchairs are available at the Balsam
entrance if needed. Follow the signs to the elevators and proceed to the
Forms for All Patients
In addition to the forms above, please complete forms below based on your
type of evaluation.
Counseling Evaluation Forms
Hand Therapy Evaluation Forms
Occupational Therapy Evaluation Forms
Physical Therapy Evaluation Forms
1 of the following based on the primary reason for your Physical Therapy
Speech-Language/Cognitive Therapy Evaluation Forms
1 of the following questionnaires based on the primary reason for your Speech
Speech-Language-Cognitive Therapy - Intake Questionnaire - If your primary problem is speech, language or cognition
Speech-Language Therapy for People with Parkinson's Disease - Intake
Questionnaire - If you have Parkinson's Disease
Swallowing Therapy - Intake Questionnaire - If your primary problem is swallowing
Voice Therapy - Intake Questionnaire - If your primary problem is your voice
Call (303) 415-4400 if questions.