Boulder Toolkit for Partners

For assistance please call our referral coordinator at 888-720-2236

Authorization form for Boulder Care Provider Group to disclose health, behavioral, and substance use disorder info.

Release of Information Form

Download and fill out the form.

Per HIPAA / 42 CFR Part 2, a completed Boulder Care Release of Information (ROI) form is legally required to release patient medical records but Medical Record Request forms are preferred

Securely send it to us:

Email: records@boulder.care
Fax to (833) 279-2791

Download the form

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Medical Records Request Form

Download and fill out the form.

Please provide your facility's fax number on our Medical Records Request form for streamlined response. If your facility does not utilize a fax machine, secure email delivery is available upon request.

Securely send it to us:

Email: records@boulder.care
Fax to (833) 279-2791

Standard record delivery is completed via fax

Download the form

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Boulder Assist Program

Financial assistance for people without insurance

Download the form

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Instructions to enroll using communal device for Boulder Care app with QR code and phone support number.

Communal Device Enrollment Instructions

How to help someone enroll from a communal computer, tablet, or phone.

Download the form

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Boulder Care flyer with telehealth info for opioid and alcohol use disorders and contact details for appointments.

Boulder Care Overview for Incarcerated Individuals

How to support incarcerated people with SUD

Download the 1-pager

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Referral 1-Pager

How to refer your patients to Boulder Care

Download the 1-pager

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Refer a patient today

We believe in integrated care, and love working with primary care providers, social workers, case managers, parole officers and others to help your patients and clients on their path to recovery.

Refer a patient