New Patients
This page contains links to patient registration forms and useful information for our new families.
Packet of New Patient Information Forms that includes:
-
- Patient / Family Information Form
- Please use full legal names of children and include middle initials.
- If your child has a preferred nickname, please include this as well.
- For parents, please use full legal names, including middle initial. This is especially true for policy holders, so that names match.
- Please use full legal names of children and include middle initials.
- HIPAA / Insurance / Acknowledgement
- Medical History
- Financial Policy
- Medical Records Transfer Request
- Whenever possible, we ask that vaccine records be requested in advance of the first appointment and either faxed/emailed to our office, or brought to the first scheduled appointment.
- Patient / Family Information Form
Complete this form to authorize additional family (step-parents/grandparents/other family) and/or friends to bring your child(ren) to appointments and make medical decisions on your behalf.
Form can be done for a specified period of time or ongoing until ended in writing.
Our office is a vaccine-only clinic. This means that children must be follow the AAP and state recommended vaccine guidelines in order to be seen in our office.
Accepted Insurance Plans:
- Aetna
- Anthem/Blue Cross Blue Shield
- Any “Pathways” or “HMO” plans must list a Parker Pediatrics MD as the primary care provider – Dr Brian Stanga / Dr Lauren Finney. Patients are still free to see any provider in our office. This is for insurance billing purposes only.
- Cigna – Most plans, but NOT the following:
- Connect
- Surefit
- Colorado Children’s Health Plan / Colorado Access (CHP/COA)
- Humana
- Medicaid/Health First Colorado
- Tricare
- Primary Care Manager must be a Parker Pediatrics MD – Dr Brian Stanga / Dr Lauren Finney. Patients are still free to see any provider in our office. This is for medical referrals and insurance billing purposes only.
- UMR
- United Healthcare
- “Navigate” Plans: Primary Care Manager must be a Parker Pediatrics MD – Dr Brian Stanga / Dr Lauren Finney. Patients are still free to see any provider in our office. This is for medical referrals and insurance billing purposes only.
If you are not a member of one of our contracted plans, we will be happy to see you under a fee-for service agreement. Payment is expected to be paid at the time of service and you will receive a copy of the fee slip to submit to your plan. We offer a discount for anyone who pays for their visit in full at the time of service.
It is your responsibility to understand your particular plan, as well as any health savings plans you may have in effect. According to your insurance plan, you are responsible for any copays, deductibles, coinsurance or non-covered services. Copays are due at the time of your visit.