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Program Forms and Handouts

This page includes various forms and documents for subrecipients, including visit templates, clinical forms, client handouts, administrative forms, and fiscal forms.

Administrative forms
  • Registration form templates, Patient bill of rights, closing and opening clinic request forms, sample client satisfaction surveys, and more. 
Clinical forms
  • Procedural consent forms, progress notes templates, and referral templates.
Cost Setting Project
  • Helpful information from the 2021 cost-setting project and the cost analysis worksheet.
Family Planning Program Data
  • Annual CDPHE Family Planning Program data points for Colorado. 
Fiscal Forms
  • Income code examples, approved sliding scale of discounts, and example of a super bill.
FPAR 2.0
  • Updates to the Title X Family Planning Annual Report (FPAR)and third-party data specifications for FPAR 2.0.
Information and Education Materials
  • Resources and materials for subrecipient I&E committees.
Sample Quarterly Report 
  • A sample quarterly report from Fiscal Year 2021-22 is provided for reference. The questions may change from year to year.
Telehealth Resources
  • Resources compiled during the COVID-19 pandemic.
Your Sexual Health Booklet
  • The Your Sexual Health Booklet is a resource for patients and community outreach activities.