Western Orthopedics & Sports Medicine, P.C.

Registration Forms

Provided below are various forms that require completion prior to your visit and/or surgery. Please download the appropriate form as directed by your physician and/or staff by clicking on the name of the form. If you cannot access the form, please click on the Adobe box. This will allow you to download this software, providing access to the forms. Please bring the completed form/s with you to your scheduled visit. This will help expedite the registration process. Thank you.

Notice of Privacy Practices Patient Information Neck/Back Pain and General History Medical Records Release

Medications List Rocky Mountain Health Plans Injury Form Injury Information

If you cannot access the forms you can click on the icon to download the software.

If you are a new patient, please print and bring with you the following completed forms:
Patient Information
Medications List (if applicable)
Injury Information

If you are a member of Rocky Mtn. Health Plans please complete the following information and call 970-243-7050 to speak with the COB department:
Rocky Mountain Health Plans Injury Form

If you are being seen for neck (cervical) pain or back pain, please complete:
Neck/Back Pain and General History

If you would like medical records from Western Orthopedics, or if you need records to be released from a physician or healthcare provider for your visit to Western Orthopedics, please complete the following:
Medical Records Release