Our Forms and Policies
New Patients:
New Patient Welcome Letter.pdf
Adobe Acrobat document [950.6 KB]
Adobe Acrobat document [950.6 KB]
New Patient Information.pdf
Adobe Acrobat document [533.9 KB]
Adobe Acrobat document [533.9 KB]
Records:
Policies:
Financial Policies.pdf
Adobe Acrobat document [867.7 KB]
Adobe Acrobat document [867.7 KB]
No Show Policy.pdf
Adobe Acrobat document [605.3 KB]
Adobe Acrobat document [605.3 KB]
Telephone Call Policy.pdf
Adobe Acrobat document [682.6 KB]
Adobe Acrobat document [682.6 KB]
Forms:
Auto Accident Form.pdf
Adobe Acrobat document [559.1 KB]
Adobe Acrobat document [559.1 KB]
HIPPA Signature Page.pdf
Adobe Acrobat document [82.2 KB]
Adobe Acrobat document [82.2 KB]
Dr Rivera's Physical Form.pdf
Adobe Acrobat document [660.9 KB]
Adobe Acrobat document [660.9 KB]
Medicare Charges:
Understanding Medicare Charges.pdf
Adobe Acrobat document [710.5 KB]
Adobe Acrobat document [710.5 KB]
Tips:
Tips for Cold and Flu.pdf
Adobe Acrobat document [987.8 KB]
Adobe Acrobat document [987.8 KB]
The Family Clinic of Fort Collins:
1212 E Elizabeth St
Fort Collins, CO 80524
Office Phone:
970-482-2791
Fax:
970-495-9843
E-Mail:
joely@familyclinicfc.com
Office Manager:
Joely Carney
Regular Office Hours:
Monday - Friday: 8am-5pm
For life threatening emergencies; CALL 911.
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