Patient Insurance & Medical Forms
Whether you’re looking for information about insurance participation or need to fill out medical forms, you’ll find everything you need right here. Find everything you need on this page regarding insurance participation or pre-appointment medical forms here.
Patient Medical Forms & Resources
General Health History for Doctor’s Appointments
We have you fill this out when you come in for a “new patient appointment” at the Orthopaedic & Spine Center of the Rockies — or if your last appointment with one of our doctors was more than a year ago.
- Patient General Health History Form
- Disability Form (Longmont, Lafayette, Westminster)
- Consent to Treat a Minor Form
OCR Longmont, Lafayette, Westminster Electronic Patient Intake System
- You will receive forms to complete prior to the visit via text link.
- You may either complete the intake on your phone or copy and paste the link to complete it on a tablet or computer.
- We kindly ask that you complete these forms in a timely manner after you receive the text link.
Your Medical Records
General Medical Records Information
We will ask you to fill out, sign and date a release form for us if you are requesting records for yourself or requesting your records to be sent elsewhere.
Requests are processed in the order received and will generally take 3-5 business days.
If you were seen more than 8 years ago, it is possible we no longer have your records.
If you had surgery at an area hospital, the hospital may have your chart. Please check with the hospital’s medical records department. If your file is still available, you will need to submit a request through the hospital.
Fort Collins, Greeley, & Loveland Medical Records Contacts
Contact our release of information coordinator at 970-419-7015 or call 1-800-722-7441 and ask for medical records.
- Phone: 970.419.7015 or 1.800.722.7441
- Fax: 970.493.0521
- Email: ROI@orthohealth.com
Longmont, Lafayette, Westminster Medical Records Contacts
- Phone: 303.772.1600
- Fax: 303.772.9317
Spine Health History Form
This form below is ONLY for those who have an appointment with Dr. Robert Benz MD or Dr. Bill Biggs MD, or Dr. Patrik Suwak DO for a spine or back/neck condition
Insurance Information
We participate with most major health insurance companies and various government programs, including Medicare, TRICARE, Medicaid, and the Colorado Child Health Plan. Kaiser Permanente insurance is also accepted at our Longmont location. Before your appointment, be sure to verify your coverage to understand any potential exclusions or limitations.
- Remember to bring your insurance ID card to each appointment
- Verify your coverage beforehand
- Notify us of any changes to your insurance information
For further assistance or questions regarding insurance coverage, please contact our business office at 970-493-5615 or dial 1-800-722-7441 and ask for the business office.
Government Programs
We also participate in these government programs:
- Medicare (patients must have Part B coverage)
- Medicare PFFS Advantage Plans
- TRICARE — Prime, Extra, Advantage, and TRICARE for Life plans.
- TRICARE requires a referral for Prime members for appts at OCR.
- Medicaid
- Colorado Child Health Plan (CCHP)
Financial Assistance
For patients seeking financial assistance, we offer the option to pay bills through the MyLoans financing program and Bank of Colorado, providing flexibility and support during your healthcare journey.
Please verify your insurance coverage for the services you need from us before your appointment. You can do this through your insurance company or the benefits office where you work.
For questions, contact our business office at 970-493-5615. Or dial 1-800-722-7441 and ask for the business office.
Transparency in Health Care Prices Act
Download the Orthopaedic & Spine Center of the Rockies Prices