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New Patient Enrollment Documentation

Please bring the following documents with you when you come to your enrollment appointment:

For CHP+/Medicaid

The following documents are helpful, but not required:

  • Driver's License/State ID
  • Birth certificates for all family members applying
  • Legal Permanent Resident card
  • Medical expenses for last three months if you are requesting retroactive Medicaid coverage
  • Health insurance information if applicable
  • Business ledgers or profit or loss statement for previous month if self-employed

For Colorado Indigent Care Program (CICP)*

  • CO Driver's License/CO State ID
  • Medicaid denial letter if applicable
  • Legal Permanent Resident card
  • Health insurance information if applicable
  • Business ledgers or profit or loss statement for previous month if self-employed
  • Proof of income for last month if employed

For Sliding Scale*

  • Driver's License/State ID
  • Medicaid denial letter if applicable
  • Legal Permanent Resident card
  • Health insurance information if applicable
  • Business ledgers or profit or loss statement for previous month if self-employed
  • Proof of income for last month if employed

For Uninsured / Sliding Scale

  • Identification card, if applicable
  • Business ledgers or profit or loss statement for previous month if self-employed
  • Proof of income for last month if employed