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Intake Forms 

Before your first appointment, please download, print and fill out the following forms and then bring them with you to your first appointment. (They are in pdf format)

Patient Information (download)

Health Insurance Portability and Accountability Act (HIPAA) (download)

Authorization for Release of Information (download)

Dr. Mark Leifeste, M.D., 4770 Baseline, Suite 300, Boulder, CO 80303