CU Outreach Forms
New Patient Forms
The following forms are for patients of CU Specialty Outreach Clinics for Children. Before completing these, please be sure to schedule an appointment.
New Patient Packets
Once you have an appointment, please print and fill out the new patient packet before you come to the office. This will help you be seen faster. If you don't have access to a printer we will provide these forms when you arrive.
The Notice of Privacy Practices document describes the University of Colorado School of Medicine and University Physicians, Inc.’s practices, uses and disclosures of your medical information.
- Advance Beneficiary Notice of Noncoverage (ABN) - English Download PDF
- Notificación Previa de No-Cobertura al Beneficiario (ABN) - Spanish Descargar PDF
- Notice of Privacy Practice Acknowledgement Download PDF
- Acuso de Recibo de Aviso Conjunto de Practicas de Privacidad Descargar PDF