- Authorization for Services Form (PDF) opens in new window
- New Injury Patient Paperwork (PDF) opens in new window
- New Injury Patient Paperwork - Spanish (PDF) opens in new window
- Non-Injury Patient Paperwork (PDF) opens in new window
- Non-Injury Patient Paperwork - Spanish (PDF) opens in new window
- Physical Examination Paperwork (PDF) opens in new window
- DOT Exam Paperwork OMB No. 2126-0006 (PDF) opens in new window
- Medical Records Release Form (PDF) opens in new window
- HIPAA Privacy Practices (PDF) opens in new window
- HIPAA Privacy Practices - Spanish (PDF) opens in new window
- Pinnacol First Fill Form (PDF) opens in new window
- Certificate of Physical and Mental Fitness CCD (PDF) opens in new window
Frequently Used Forms
To further expedite the process of receiving services at Injury Care Associates, we have our most-commonly used forms available for download. Please bring a completed copy of the paperwork relevant to your services to your appointment. If bringing completed paperwork with you to your appointment, please print the paperwork one (1) sided.
Remember, appointments are not required at Injury Care Associates and completing paperwork in advance of your visit is not required.
Note that for all Federal (DOT) physical examination and drug and alcohol testing services, a valid Driver's License is required in order to complete these services.