Colorado Doctor's Lien and Patient Consent

Claim a lien for medical services to make sure you get paid. Have your patients sign this Colorado Doctor's Lien and Patient Consent at the time that treatment is provided.

• The patient consents to the treatment and authorizes the medical facility to release his/her patient information regarding the accident or injury for which the patient is being treated, for purposes of the injury claim.
• The patient agrees to be personally liable for paying the medical provider's fees regardless of the outcome of the patient's claim.
• The patient gives the medical provider an irrevocable lien on any settlement or damages awarded to the patient and directs his/her attorney to satisfy the lien out of those proceeds.
• The patient will notify the medical provider if he/she retains new legal counsel.

Don't risk not being paid for your services. Get this Colorado Doctor's Lien and Patient Consent form today.