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Pediatric Partners of the Southwest
Medical Records Release Form


Click here to open the form to request records from your child's previous medical provider(s). This can be used to request records to be sent to us (for new patients), or to have us send records to your new doctor. Please fill out one for each prior provider, and email back to us at

          Click here for the Spanish form

Non-Medical Vaccine Exemption Policy

          Click here to view PPSW's information about 2021 changes to the Colorado law about non-medical vaccine              exemptions.

New Patient Packet


Click here to print the 3-page New Patient Information Pack in English.

Click here for the 3-page New Patient Information Pack in Spanish

and here to print the Medical History Form

Please fill out the forms and bring with you to your first appointment. 

Sports Physical Forms


School Sports Physical Form

     - used at Bayfield and Durango schools


Alex Shackel
Tele-Health Forms
Tele-Health Forms


Tele-Health Technology Requirements

Consent for Tele-Health Service

Young Adult Forms


          Consent to Share Medical Information for Patients over 18

HIPAA Privacy Practices

          Click here for our HIPAA Notice of Privacy Practices form

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