School/Camp/Daycare Forms

School/Camp/Daycare Forms Policies:

  1. Blank forms will not be accepted. Please complete form in its entirety (patient info, names of medications and doses, etc.). Blank forms will be returned unsigned.
  2. Due to HIPAA and best privacy and security practices, we will return forms via mail or place for pickup at one of our 4 office locations. Faxing and emailing are not secure methods of transferring personal health information.
  3. Turn around time will depend on current volume of requests but please anticipate 3-5 business days. If you drop off and pickup your request at the same office location this may expedite your turn around time.
  4. No form will be completed unless a well child checkup has occurred in the past 12 months (an office visit or medication check will not be considered). Please call our office and verify the date of last well care if you are uncertain prior to form submission.
  5. Forms to be completed may be mailed to our Elizabeth Office (1200 East Elizabeth, Fort Collins, CO 80524), dropped off at any one of our four office locations or uploaded here online.  For uploads, we will only accept patient forms (for schools, daycares etc). Please do not upload other office forms such as medical records, registration paperwork, insurance or new patient forms.  Please note the only options to return your submissions will be for us to mail to your home address on file or for you to pickup.

School, Camp Or Daycare Form Upload ONLY: