Medical Forms

For your convenience, we provide standard medical forms that can be filled out online or downloaded, printed and filled out before coming in for your appointment. For forms that have online submission capabilities, an "Online Form" button will display next to the "Download Form" button. Thank you for choosing Conifer Medical Center for your healthcare needs.

Administrative Forms

HIPAA Privacy Policy

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Patient Information and Privacy Policy Acknowledgement

Online Form Download Form

Request For A Copy Of Your Medical Records

Online Form Download Form

Child Development Forms

2 Month Well Child Checkup

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4 Month Well Child Checkup

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6 Month Well Child Checkup

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12 Month Well Child Checkup

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18 Month Well Child Checkup

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24 Month Well Child Checkup

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36 Month Well Child Checkup

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48 Month Well Child Checkup

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60 Month Well Child Checkup

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Conifer Medical Center is devoted to the care of our community.

We are offering Televisits and limited office visits with providers 6 days a week (please call for hours).

Please call the office at 303-647-5300 and we will be happy to discuss if you are appropriate for an “in-office” visit vs a Televisit.

If you are experiencing COVID-19 (or similar) symptoms, please call our office at (303) 647-5300 and we would be happy to talk with you over the phone. Please do not come to the office as we are not testing for COVID-19 (Coronavirus).

Thank you for your understanding, and we wish everyone well.
Conifer Medical Center is devoted to the care of our community.

We are offering Televisit with providers 7 days a week (please call for hours).
We are also currently operating with a limited “in-office” staff who will be seeing only patients in person that are in need of urgent medical care (cuts, broken bones, etc.). This does NOT include upper respiratory infection, fever and cough symptoms.

Please call the office at 303-647-5300 and we will be happy to discuss if you are appropriate for an “in-office” visit vs a Televisit.

* Note: We are able to provide remote (Televisit) care for NEW patients but are NOT able to offer Controlled Substance Medications to NEW patients.

If you are experiencing COVID-19 (or similar) symptoms, please call our office at (303) 647-5300 and we would be happy to talk with you over the phone. Please do not come to the office as we are not testing for COVID-19 (Coronavirus).

Thank you for your understanding, and we wish everyone well.
Conifer Medical Center’s
8th Annual Health in the Hills
WHEN: Saturday, September 21, 2019
8 am to 11am
WHERE: 26659 Pleasant Park Rd., Conifer, Colorado
Lab Tests Offered:

Comprehensive Metabolic Panel   $10.00
Lipid panel                                              $20.00
Hemoglobin A1c                                    $12.00
Vitamin D                                                 $40.00
Thyroid-stimulating hormone       $15.00
Prostate-specific antigen               $15.00
Complete Blood Count                      $10.00
Conifer Medical Center’s
8th Annual Health in the Hills
WHEN: Saturday, September 21, 2019
8 am to 11am
WHERE: 26659 Pleasant Park Rd., Conifer, Colorado
Lab Tests Offered:

Comprehensive Metabolic Panel   $10.00
Lipid panel                                              $20.00
Hemoglobin A1c                                    $12.00
Vitamin D                                                 $40.00
Thyroid-stimulating hormone       $15.00
Prostate-specific antigen               $15.00
Complete Blood Count                      $10.00