Forms

ADA Claim Form Example
Assistant Surgeon Report
Authorization for Treatment Form
Direct Deposit and ACH Authorization Form
Health First Colorado Dental Non-Covered Service Disclosure Form
Health First Colorado Orthodontic Termination of Care Form
Health First Colorado Orthodontic Continuation of Care Submission Form
Health First Colorado Orthodontic Transfer Cases
Health First Colorado Orthdontic Criteria Index Form - Comprehensive Treatment
Health First Colorado Orthdontic Criteria Index Form - Interceptive Treatment
Listing of Colorado County Departments of Human & Social Services
Listing of Community Centered Boards (CCB) and Map
Medical and Dental History
Pediatric Oral Health Screening Form - For Dental Office Settings (Cavity Free at Three)
Pediatric Oral Health Screening Form - For Medical Office Settings (Cavity Free at Three)
Recall Examination Form
Request for Transfer of Records Form