A Woman's Place
  • Home
  • Medical Spa
  • Providers
  • Patient Forms Insurances Accepted Patient Resources News & Updates
  • Contact Us
A Woman's Place
  • Home/
  • Services/
    • Medical
    • Spa
  • Providers/
  • Patient Resources/
    • Patient Forms
    • Insurances Accepted
    • Patient Resources
    • News & Updates
  • Contact Us/
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A Woman's Place

2620 E. Prospect Rd. Ste. 160 Fort Collins 970.221.4977

Patient Forms

A Woman's Place
  • Home/
  • Services/
    • Medical
    • Spa
  • Providers/
  • Patient Resources/
    • Patient Forms
    • Insurances Accepted
    • Patient Resources
    • News & Updates
  • Contact Us/

Please download and complete the applicable forms and bring them to your appointment: 

General Forms

Patient Intake Form
HIPPA Letter
Privacy Practices and Patient Disclosure Form
Financial Policy Form
Patient History Form
Medical Release Form To AWPFC
Medical Release Form From AWPFC
Care Agreement


Maternity Forms

Important OB Notices
Rx's you may take during your pregnancy
Remedies for morning sickness
PVHS Pre-Registration Form
FMLA Disability Paperwork
Perineal Massage In Pregnancy


A Woman's Place Fort Collins - 2620 E. Prospect Rd. Ste. 160 Ft. Collins - 970.221.4977 - Monday through Friday 8-5