Firststfamilyhealth.com

First Street Family Health

WEB719-530-2250 / Dial 911. 1000 Rush Drive Salida, CO 81201. 24/7 Emergency Care. Thank you again for your patience and understanding during this process, First Street Family …

Actived: 2 days ago

URL: https://firststfamilyhealth.com/

First Street Family Health Merger with Heart of the Rockies …

WEBthe Salida Health Center (HRRMC Salida Health Center, 550 US-50, Salida, CO 81201) with a tentative start date of September 7 th. Dr. Burkley’s patients must call …

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First Street Family Health Will Permanently Close August 31 , …

WEBSarah will be seeing patients at the Salida Health Center (HRRMC Salida Health Center, 550 US-50, Salida, CO 81201) with a tentative start date of August 30th. Dr. Burkley's …

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Medicare Wellness checkup

WEB12. Because of any health problems, do you need the help of another person with your personal care needs such as eating, bathing, dressing, or getting around the house? l …

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Patient Portal User Agreement

WEBFirst Street Family Health, in partnership with Updox, offers a Patient Portal for the exclusive use of our established patients. The Patient Portal is designed to enhance …

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Sliding Fee Policy

WEBDiscount Fee Policy This practice is committed to serving all patients. You will not be denied services based on inability to pay. This policy is posted in our waiting area.

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Patient Agenda Name:

WEB6/17/2016 Patient Agenda Name: _____ List ALL concerns you wish to discuss at this visit. Remember: There may not be time to discuss Check any requests you have for this …

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Sliding fee application

WEBDiscounted Fee Application Discounts are offered to uninsured patients based upon family/household size and annual income. A sliding fee schedule is used to calculate the …

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INTRODUCE HAPPY TO WE'RE

WEBHRRMC SALIDA HEALTH CENTER. 550 us-50, Salida, CO 81201 719-530-2022. Patient Reminder: Dr. Matthew Burkley's patients are strongly advised to call Salida Health …

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PHYSICAL EXAMINATION AND PARENT PERMIT

WEBNOTE: It is strongly recommended by the Colorado Department of Health that individuals participating in athletic events have current tetanus boosters. Tetanus boosters are …

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HEALTH HISTORY QUESTIONNAIRE

WEBHEALTH HISTORY QUESTIONNAIRE All questions contained in this questionnaire are strictly confidential and will become part of your medical record. Name (Last, First, M.I.): …

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HIPAA AUTHORIZATION FOR USE OR DISCLOSURE OF …

WEBI authorize _____ to use or disclose the following health information: All of my health information My health information relating to the following treatment or condition: _____ …

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Patient Financial Policy and Agreement

WEBI acknowledge that I have received and read a copy of the First Street Family Health Office Policies and Patient Financial Policy and Agreement. I authorize and consent to the …

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Effective 07/09/2020

WEBWe can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage …

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Patient Portal Acknowledgement and Agreement

WEBFAMILY HEALTH . Author: Katrina Martinez Created Date: 12/2/2019 3:44:15 PM

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Sliding Fee Schedule

WEBPoverty Guidelines, all states (except Alaska and Hawaii) 2019 Annual 50% *100%* 125% 130% 133% 135% 138% 150% 175% 185% 200% 250% 300% 400% 1 6,245 $12,490 …

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Ages & Stages Questionnaires 48 Month Questionnaire

WEBCOMMUNICATION (continued) 5. Without your giving help by pointing or repeating, does your child fol-low three directions that are unrelatedto one another? Give all three

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Notice to Individuals Regarding Privacy Incident

WEBFirst Street Family Health (“FSFH”) is providing notice to individuals about a privacy incident it discovered on July 16, 2022. Parts of FSFH’s computer network were subject …

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Ages & Stages Questionnaires 20 Month Questionnaire

WEBFINE MOTOR (continued) 6. Does your child use a turning motion with her hand while trying to turn doorknobs, wind up toys, twist tops, or screw lids on and off jars?

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Ages & Stages Questionnaires 14 Month Questionnaire

WEB3. Does your baby stand up in the middle of the floor by himself and take several steps forward? 4. Does your baby climb onto furniture or other large objects, such as

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The medical information found on the MediWells website is designed to support, not to replace the relationship between patient and physician and the medical advice they may provide.