Logo for Prime Health with the slogan Where care comes together. The bold teal and brown text and geometric cross highlight our commitment to quality healthcare, making it a standout choice for Grand Junction Health Care needs.

Patient Forms

reception area at primehealth plus new main health and dental clinic in grand junction, colorado

Find the Right Forms

Welcome to PrimeHealth+! To help make your visit smooth and efficient, we encourage all new and returning patients to complete the necessary forms before your appointment. Whether you’re joining us for medical, dental, or behavioral health visits, you’ll find everything you need right here. Some of these forms are available to fill and submit online, while others are printable for you to bring to your appointment.

Patient Forms

Simple line drawing of a person behind a shield with a medical cross, symbolizing affordable health care and protection, perfect for representing Grand Junction Health Care or general medical insurance.
New Patient Forms
A turquoise outline of a hand facing upward with a coin featuring a dollar sign hovering above the palm, symbolizing affordable health care and accessible services in Grand Junction Health Care.
Financial Assistance Forms​
Two blue outlined hands are open and facing upward, supporting a light blue heart with a medical cross symbol in its center, representing Grand Junction Health Care and comprehensive healthcare support.
Medicare Forms​
A simple blue line drawing of a graduation cap with a tassel hanging down from the right side, symbolizing achievement in affordable health care and education.
School-Based Clinic Forms​
Simple blue line drawing of a flexed human arm showing a prominent bicep muscle, symbolizing strength and fitness—an ideal representation for promoting affordable health care or wellness at Montrose Health Care.
Sports Physical Forms​
Simple line drawing of a tooth with a magnifying glass focused on its side, suggesting an affordable health care dental examination or oral health checkup.
Dental Forms​
A simple illustration of a smiling mouth with several missing teeth, outlined in blue, representing the need for affordable health care.
Smart Smiles Dental Forms​
A blue icon of a computer monitor displays a heartbeat-like line graph and vertical bars, symbolizing data analysis or health monitoring—ideal for representing affordable health care solutions.
Patient Portal​

Make PrimeHealth+ your medical and dental home by following the steps below:

1. Schedule Your Appointment

Appointments are easy to schedule. Simply call us at (970) 200-1600 to book your new or follow-up patient visits at any of our health clinics.

2. Complete Your Forms

Complete and submit these forms ahead of your appointment.

Simple line drawing of a person behind a shield with a medical cross, symbolizing affordable health care and protection, perfect for representing Grand Junction Health Care or general medical insurance.
Two blue outlined hands are open and facing upward, supporting a light blue heart with a medical cross symbol in its center, representing Grand Junction Health Care and comprehensive healthcare support.

New Patient & Medicare Forms

New Patient Medical Registration English | Español

Medical Release of Information Authorization Form:

For Medicare Patients Only: Medicare Annual Wellness Visit Questionnaire (annual preventative care planning visit) English | Español

Release information TO PrimeHealth+ (English & Spanish combined)
Release information TO PrimeHealth+ (English & Spanish combined)
Release information TO PrimeHealth+ (English & Spanish combined)
Release information TO PrimeHealth+ (English & Spanish combined)
A turquoise outline of a hand facing upward with a coin featuring a dollar sign hovering above the palm, symbolizing affordable health care and accessible services in Grand Junction Health Care.

Financial Assistance Forms

We encourage everyone (both new & returning patients) to apply for financial assistance as you may qualify for more than you expect. This form determines your qualification for our sliding fee discount scale.

Financial Assistance Application | English | Español

A simple blue line drawing of a graduation cap with a tassel hanging down from the right side, symbolizing achievement in affordable health care and education.
Simple blue line drawing of a flexed human arm showing a prominent bicep muscle, symbolizing strength and fitness—an ideal representation for promoting affordable health care or wellness at Montrose Health Care.

Integrated School-based Clinic Forms
(Central High and Grand Junction High)

For patients of school-based clinics only:

Simple line drawing of a tooth with a magnifying glass focused on its side, suggesting an affordable health care dental examination or oral health checkup.
A simple illustration of a smiling mouth with several missing teeth, outlined in blue, representing the need for affordable health care.

Dental & Smart Smiles Forms

Parental Consent for Smart Smiles in-school dental screenings:

NOTE:  Dental Clinic Registration and related forms will be completed upon scheduling or at your appointment.

3. What to Bring to Your Appointment​

Please arrive 30 minutes early to confirm all your paperwork. Please make sure to bring your:

  • Photo ID (any photo identification card, such as a driver’s license or passport)
  • List of all medications & dietary supplements
  • Medical history information
  • If you have insurance, bring your health insurance card, Medicare card, Medicaid card and copayment as required by your insurance.
  • If uninsured or applying for sliding fee discounted care, bring your completed Financial Assistance Application and required documentation if not submitted online.
A close-up of a person’s hands using a smartphone, engaging with a healthcare app—perfect for Grand Junction Health Care or Montrose Health Care services on the go.

Patient Portal Access

Do you prefer to view your medical records, send a message to your provider, or review test results on your own schedule? Sign up for the PrimeHealth+ Patient Portal for secure, convenient access to your medical health information—anytime, anywhere.

  • Communicate with your provider
  • Request prescription refills
  • Manage your appointments
  • View visit summaries, test results, and vitals

Grand Junction patients:

Click here

Montrose patients:

Click here

If you would like access to the portal but don’t already have a login, please call or talk to the front desk staff and an invitation or activation code will be sent to you to sign up. Give us a call to request your email invitation:
(970) 200-1600.

Logo for Prime Health with the slogan Where care comes together. The bold teal and brown text and geometric cross highlight our commitment to quality healthcare, making it a standout choice for Grand Junction Health Care needs.