Records Request
To initiate a request for records from Aspen Hope Center simply download, print, complete and sign the following form:
Instructions: Please complete the form in its entirety and email with photo identification to: records@aspenhopecenter.org
Please note, Photo Identification is required from the person requesting and/or receiving records.
Important Definitions:
A Personal Representative is an individual who has legal authority to act on behalf of a client in matters related to healthcare decisions and access to protected health information (PHI). Documentation verifying legal authority may be required before records are released.
Examples of a Personal Representative may include:
A parent or legal guardian of a minor child
A court-appointed guardian or conservator
A Designated Recipient is a person or organization that a client (or their Personal Representative) authorizes Aspen Hope Center to send records to.
Examples of a Designated Recipient include:
An attorney
Another healthcare provider
A school or educational institution
Minor Consent Note:
In some situations under Colorado law, minors starting at the age of 12 may consent to their own mental health services. When this occurs, authorization from the minor may be required before records can be released, including to parents or guardians, unless otherwise permitted by law.