Records requests:
please download and complete a release_of_information form and fax (801-447-5248) or email (rgeorge@brighterdaytms.com) with phone number and fax number or email of provider or person to send the records to.
NOTE: after the first records request there will be a $50 fee for each subsequent record request to be paid prior to records released.
Contact Information:
phone: 970-430-5458 Fax: 801-447-5248 or mail to: Attn: Dr. Rose George; 4103 Boardwalk Dr.; Fort Collins, CO 80525
Release of information (please print one out for each provider currently seeing whom Dr. George would need records from, or to send information to, and bring to first visit completed with contact information for providers)
please note a fee schedule for self pay is as follows
new patient visit - 60 minutes $350
55 minutes therapy and medication management appointments $25
45 minutes therapy and medication management appointments $200
25 minutes medication management $150
please download and complete a release_of_information form and fax (801-447-5248) or email (rgeorge@brighterdaytms.com) with phone number and fax number or email of provider or person to send the records to.
NOTE: after the first records request there will be a $50 fee for each subsequent record request to be paid prior to records released.
Contact Information:
phone: 970-430-5458 Fax: 801-447-5248 or mail to: Attn: Dr. Rose George; 4103 Boardwalk Dr.; Fort Collins, CO 80525
Release of information (please print one out for each provider currently seeing whom Dr. George would need records from, or to send information to, and bring to first visit completed with contact information for providers)
please note a fee schedule for self pay is as follows
new patient visit - 60 minutes $350
55 minutes therapy and medication management appointments $25
45 minutes therapy and medication management appointments $200
25 minutes medication management $150
| release_of_information_consent.doc |
