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  WMC Main
  • Home
  • Who We Are
    • Locations >
      • Main - Westminster
      • South - Lone Tree
    • Care Teams & Providers >
      • Meet the Team
    • Administration
    • Initiatives and Awards
    • Join WMC
  • Services
    • New Patients
    • All Services
    • Pediatrics
    • Behavioral Health & Loneliness
    • Health Coaching & Weight Loss
    • Advanced Heart Care
    • Advanced Care Planning
    • Supplements
    • Center for Personalized Medicine™
    • WMC Direct™
  • Community
    • Patient Advisory Council
    • Events, Volunteering, & Kid's Club
    • Community Partnerships
    • WMC Pantry & Support Resources
    • Educational Webinars
    • The Pulse Newsletter
  • Portal, Forms, & Costs
    • Patient Portal
    • Portal FAQs & Info
    • Forms
    • Costs for Care
    • Payment Policy
    • Insurance & Pay My Bill
    • The Patient Profile©
    • Notice of State Registry
  • Contact Us

Forms

Patient Forms

We offer language assistance and American Sign Language (ASL) interpretation services for our patients. Please notify us if you primarily speak a language other than English or communicate using ASL and would like interpretation assistance at your appointments.
Forms can be challenging, frustrating, irritating, and annoying (need we go on?). Providers and staff feel the same way. WMC pledges to only give out forms when absolutely in your best interest or as a regulation requirement. WMC does need forms completed at specific times to provide you with the high-quality, safest care. The care we give, even if it includes forms, is the same care we want for our family and friends. Thank you in advance for your sensitivity and agreeing to completing our forms!

Completed forms may be emailed to us at wmc.front@westminstermedicalclinic.com

New Patients
​(all ages)

s Please click the below links to complete these forms electronically prior to your first visit at our office.

Authorization to release medical records

Consent to treat a minor
(for patients under age 18)

Long-Term Controlled Substance Agreements between a provider and person
  • Opioids Agreement
  • Stimulants Agreement Coming soon! 
  • Benzodiazepines Agreement Coming soon! 

Current Patients (all ages)

Please complete the Patient Information Update each calendar year prior to your visit at our office.

You may request medical records by completing the Authorization to release medical records. Use this form to request a personal copy of your medical records, send your records to an outside entity or transfer records from a different clinic to WMC.

For patients under age 18, please complete the Consent to treat a minor only once. All children with the same parent/legal guardian may be listed on this form. (If you have already completed this form previously, please skip this form. Please contact our office with any questions about this form or if you are unsure whether you should complete this form.)


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  • Home
  • Who We Are
    • Locations >
      • Main - Westminster
      • South - Lone Tree
    • Care Teams & Providers >
      • Meet the Team
    • Administration
    • Initiatives and Awards
    • Join WMC
  • Services
    • New Patients
    • All Services
    • Pediatrics
    • Behavioral Health & Loneliness
    • Health Coaching & Weight Loss
    • Advanced Heart Care
    • Advanced Care Planning
    • Supplements
    • Center for Personalized Medicine™
    • WMC Direct™
  • Community
    • Patient Advisory Council
    • Events, Volunteering, & Kid's Club
    • Community Partnerships
    • WMC Pantry & Support Resources
    • Educational Webinars
    • The Pulse Newsletter
  • Portal, Forms, & Costs
    • Patient Portal
    • Portal FAQs & Info
    • Forms
    • Costs for Care
    • Payment Policy
    • Insurance & Pay My Bill
    • The Patient Profile©
    • Notice of State Registry
  • Contact Us