Physician Clinics

New Patient Packet Forms

Please complete the forms for the following provider of your scheduled appointment.

●Valerie Carnes, AGNP-C (La Junta)
719.383.5960
1100 Carson Avenue, Suite 100
La Junta, CO 81050
New Patient Form

●Emily Garcia, FNP-C (Rocky Ford)
719.383.6113
1016 Elm Avenue,
Rocky Ford, CO 81067
New Patient Form

●Jessica Ojeda, ACNPC-AG (La Junta)
719.383.5906
1100 Carson Avenue, Suite 201
La Junta, CO 81050
New Patient Form