Patient Education & Forms

Patient Education

Below you will find additional information regarding care you may be receiving at Weiss Medical Associates. It is important to us that you are fully informed, prepared for and comfortable with any treatments or procedures that have been recommended for you. If you have any additional questions, please don’t hesitate to ask us.

Preparing for Your MRI

Preparing for VAX-D


Patient Forms

To help us provide you with the best patient service possible, we have made all patient forms available online. For New Patient forms, please print, complete by hand, and bring them with you to your appointment. Any other completed forms (Other Forms, below) may be faxed to (970) 777-5161. All forms require Adobe Acrobat Reader to view.

Please remember to bring your insurance card(s), driver license/ID card, and any pertinent records or test results (including actual films) to new patient appointments. If a case is in litigation and being handled by an attorney, a letter of protection (LOP), along with insurance information, will also be required at the initial evaluation.

Please note that showing up late for an appointment could result in having your appointment rescheduled. Also, failure to cancel or reschedule within 24 hours prior to your appointment time could result in a cancellation charge. Please see our policies for more information.

NEW PATIENT FORMS

Preparing for Your Initial Appointment
Patient Demographic Form
WMA Notice of HIP
Patient Acknowledgment Form
Authorization to Disclose
Medical History (please be sure to include name and date on top of form)

 OTHER FORMS

Request for Medical Records
•  MRI Request Form for referring physicians
•  MRI Safety Checklist

 


Testimonials
My MRI was such a relaxing experience, I actually had fun!
Albert Timroth

Weiss Medical Associates

3971 Bighorn Rd 7DD
Vail, CO 81657

485 Lindbergh Drive
Gypsum, CO 81631

970.477.0700