Centura Health

 
  • Text Version
  • | Change Text Size: Decrease (-) Restore Default Increase (+)
Centura Health

Avista Family Medicine New Patient Forms

Thank you for choosing Avista Family Medicine. At each of our three locations in Boulder and Erie will make every effort to make your visit as pleasant as possible. Our primary care doctors will look at the whole person, treat most conditions and refer when appropriate.

For your convenience you can download new patient forms and complete prior to your appointment. It is very important that you complete these forms as accurately and completely as possible and bring them with you to your appointment. If you have any questions about how to complete the forms, please call our office and we can assist you. Please complete and return the forms based your type of visit:

All New Non-Medicare Patients
Download Avista Family Medicine Patient Intake Packet
All New Medicare Patients
Download Avista Family Medicine Medicare Patient Intake Packet
Non-Medicare Patients returning for yearly wellness appointments
Download the Yearly Adult Wellness Review
Medicare Patients returning for yearly wellness appointments
Download the Medicare Health Risk Assessment
Pediatric New Patient Forms - please complete if you are bringing your child for a new appointment
Download New Pediatric Patient Forms
 

Notice of Privacy Practices


Text Only Options

Change the current font size: larger | default | smaller

Current color mode is Black on White, other available modes: Yellow on Black | Black on Cream

Current color mode is Yellow on Black, other available modes: Black on White | Black on Cream

Current color mode is Black on Cream, other available modes: Black on White | Yellow on Black

Open the original version of this page.