Denver Health Referral Form 2025

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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Please fax the completed request form to (843) 792-2995 along with relevant medical records.
Referral Request Form To request a referral, please have the UnitedHealthcare Community Plan members assigned primary care provider (PCP) complete, sign and submit this form. Fax the form to 8886242748.
To refer a patient, download and fill out the Denver Health Referral Form. Send the completed form by fax to 720-956-2320 or use EpicCare Link.
If you live outside of Denver County, you can always receive emergency medical care at Denver Health, even if you qualify for Medicaid or CHP+. You MUST live in Denver County to receive non-emergent care at Denver Health under the CICP, HDC and DFAP programs.
CICP is a state of Colorado program that helps Colorado residents who are not eligible for Medicaid or CHP+. Eligibility is based on family size, income and resources. CICP is not health insurance, and is not accepted by all hospitals and doctors.

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The Denver Health 24-hour Nurseline is also available and provided exclusively to Denver Health patients and the people of Denver. Our caring medical staff quickly provide medical assistance, care advice and help you know if you need to be seen right away by a doctor. Call the Nurseline at 303-739-1211.
Schedule an Appointment By Phone: Patients can also call the Denver Health appointment center at (303) 436-4949.
If you would like to refer a patient, please fill out the following form and fax it to 310-825-7642 or e-mail it to TMSReferrals@mednet.ucla.edu.

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