New Patients

New Patients

Upon your first visit to Broomfield Family Practice please bring:

  • Picture ID
  • Insurance Card
  • Written list of questions and/or concerns
  • Written list of medications
  • Medical Records/test results

Patient Forms

Policies & Procedures
Notice of Privacy Practices
Health History Questionnaire
Health History Questionnaire: 17 Years Old and Under
Medical Release Form
Phone Message Consent – Confidential Communication Authorization
Allergy Screening Questionnaire
Consent to Discuss Private Healthcare Information

Policies

Cancellation Policy

We realize patients may need to change their appointments; however, we require a 24-hour notification of cancellation of your appointment so we may offer that time to another patient. If you fail to cancel your appointment in a timely manner, you may be billed for the scheduled time.

Prescription Refills

Please call your pharmacy for refills even if you have no refills remaining.  Please allow 48 hour turn around time.

Insurance and Billing

Each time you visit, please bring your insurance card for verification and eligibility. Co-payments are required at the time of service unless otherwise specified by procedure or insurance plans. Our staff will be happy to file your insurance claims for you. We accept cash, check or major credit cards (Visa and MasterCard). If you have special needs or questions regarding your bill, please contact our billing office at 720-508-3120.

Medical records

Patients may request copies of their medical records. A medical records release form must be signed by the patient prior to any record release. There is no charge if records are sent directly to another health care provider. There is a standard charge for records released to the individual.

Privacy

We will make every effort to maintain confidentiality of your medical records in accordance with both state and federal laws. A notice of privacy statement will be made available to each patient at the time of visit or you can locate them in the links listed above under the heading patient forms.

Insurance and Billing

Each time you visit, please bring your insurance card for verification and eligibility. Co-payments are required at the time of service unless otherwise specified by procedure or insurance plans. Our staff will be happy to file your insurance claims for you. We accept cash, check or major credit cards (Visa and MasterCard). If you have special needs or questions regarding your bill, please contact our billing office at 720-508-3120.

 

1420 West Midway Blvd., Broomfield, CO 80020   Phone: (303) 466-1866    Fax: (303) 466-4081