The following forms must be filled out, faxed to 970-686-8759 or returned at first treatment:
Consent for Care and Treatment
The Consent for Care and Treatment form gives your consent for Douglas Dewey, PT, LLC to furnish medical care and treatment to you as a patient, authorizes Douglas Dewey, PT to release all information, including medical records to your medical provider, if necessary.
Please use this form for consent for care and treatment, as well as for payment. (View and Print – pdf)
The Patient Medical History form provides information needed to build your treatment plan. (View and Print – pdf)
This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or healthcare operations and other purposes that are permitted or required by law. (View and Print – pdf)