255 Union Boulevard, Ste. 200, Lakewood, CO 80228 | tel: 303-763-5111 | email: info@redrocksobgyn.com Patient Forms New Patients If you are a new patient, or have not been to our office in the past 3 years, you should have received an e-mail invitation to our Patient Portal. Please register via the e-mail link, and complete your Health History prior to your scheduled appointment. CONNECT TO PATIENT PORTAL Please log into your Patient Portal account. On the left side bar, go to My Health, then Medical Forms. Print out, complete and sign both the HIPAA Consent and Contact form, and the Patient Financial Policy form, and please bring these completed documents to your visit. The HIPAA policy affects the use and disclosure of your personal health information and acknowledges that you have read the HIPAA Notice of Privacy Practices. HIPAA Policy and Patient Financial Policy Release of Medical Records If you need to transfer any pre-existing records from another practice/facility to our office, please print out and complete this form. You may bring this form with you to your appointment or fax this form prior to this appointment. • Release of Medical Records TO Red Rocks OB/GYN If you need us to transfer your medical records to another provider, please download and fill out this form. • Release of Medical Records FROM Red Rocks OB/GYN Medicare Patients There are certain services that are not covered by Medicare. You need to have know this information in order to make an informed decision about whether you wish to have these services. There may be other recommended services that Medicare may not cover, and we will do our best to inform you of these services should they be recommended. Please feel free to discuss this with our office at 303-763-5111. Make an appointment with us. Learn more > home | services | providers | patient forms | FAQS | research | contact 255 Union Boulevard, Ste. 200, Lakewood, CO 80228 303-763-5111 (main line) | 720-382-1850 (appointments line) Red Rocks Ob/Gyn is a proud division of Ob/Gyn Affiliates of Denver Medical Group www.obga.net