Get a Head Start!
Find what you need in our Forms & Financing section! From requests to FAQ sheets, get a head start on filling out the forms you need. If you have any questions, feel free to call us at 970-247-5874!
Cortez Office
Forms & Financing
Click the links below to download and print the forms you need!
All forms are in PDF format.
- HIPAA Privacy Notice and Acknowledgement
- Risks and Limits of Orthodontic Treatment
- Insurance Request Form
- Food Warnings List
- Retainer Instructions
- Essix (Clear) Retainer Instructions
- Monthly CC/ACH Form
- Child patient medical history form
- Adult patient medical history form

