Medical Record & Other Forms

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

 

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 for a spine or back/neck condition.

Patient Spine Health History Form

 

Your Medical Records

To learn whether we have your chart, contact our release of information coordinator at 970-419-7015. Or call 1-800-722-7441 and ask for medical records. You may also send an email to info@orthohealth.com

If we have your records, we will ask you to sign and date a consent form for us. Our fax number at OCR for patient records is 970-493-0521.

Here is a link to our records release form:

Medical Records Consent Form 

If you want us to send the copy of the records to you, leave the physician section blank or write “patient” or “self” in that space.

We keep patients’ charts for about 8 years. If your surgery or office appointments are older than that, it is possible we no longer have your records.

If you had surgery at an area hospital, the hospital may have your chart. Check with the hospital medical records department. If your file is still available, you will need to sign a release form for the hospital.