Welcome, and thank you for choosing Longs Peak Sports Medicine
for you and your family’s healthcare needs!
Before your first visit to LPSM you will need to download, print and fill out the forms below. You may bring them in with you to your appointment, or to expedite the process you may fax them to our secure line at 303.772.8207 or mail them to the office. Also, please bring your current insurance card and photo ID to your visit.
- New Sports Medicine Patient – Adolescent Health History
- New Sports Medicine Patient – Adult Health History
- Sports Physical
- Financial Policy
- Notice of Privacy Practice
(You may review or print for your records)
- Acknowledgement of Privacy Practices and Signature Verification Form
- Missed Appointment Policy
If your insurance company requires a copay, please note we will collect this when you check in. If you have a high deductible with your insurance plan and have not met the deductible total, you may be required to pay at least one half of the charges you incur at the time of your visit. You will be responsible for any remaining balance after the claim has been processed by your insurance company. If you are self pay, you will be required to pay $100.00 at the time you check in, and the front desk will collect the remainder when you check out.
We gladly accept visa, mastercard, discover, personal checks and cash.
We would like to have a copy of your previous medical records. You may fill out the request below and either bring your records, have your previous doctor send them, or have our office acquire them.