Please fill out these three forms and submit them online (or print and fax them if you prefer to (303) 484-4087) via our secure server. This is encrypted and HIPAA compliant to ensure your confidentiality. After we receive these forms, we will contact you to proceed further.
Please fill out the referral form if you are referring a patient (and/or call us at (303) 823-4882):
Providers may also use this form to confirm that a patient has been under their care:
Existing Patients: Please fill out the Pre-Infusion Questionnaire the morning of your next infusion. You may fill out the Informed Consent form as well, if you have no questions for Dr. Grindle, or you may wait until you have spoken with him just before the infusion: