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Northern Colorado Orthopedic Associates 2121 E. Harmony Rd. Suite 290 Ft. Collins, CO 80528 9702249890 (office) 9702249800 (fax)AUTHORIZATION FOR THE USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION
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Norformrn Colorado Orthopedic Associates is a medical practice specializing in orthopedic care.
Patients who have received orthopedic care from Norformrn Colorado Orthopedic Associates are required to fill out the form.
The form can be filled out by providing all necessary personal and medical information as requested.
The purpose of the form is to collect and document important medical information related to orthopedic care.
Information such as patient demographics, medical history, current medications, and orthopedic treatment received must be reported on the form.
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