Form Test - Emergencies in Medicine

Provider profile request

I would like to...*
Add a provider
Edit a provider
Remove a provider
Name of provider needing edits*
First Last
Name of provider needing removal*
First Last
Reason for removal
Fill out information below for fields that you want to change or make additions to. If nothing needs to be changed, you do not need to fill out.
Name*
First Middle initial Last Suffix
Name
First Middle initial Last Suffix
Provider group*
- Preferred (employed)
- In-network
- Out-of-network
Start date
NPI number
Profile Image
Accepted file types: jpg, png.
Primary Phone
(not needed if linked to a clinic and can use clinic number)
Primary fax (optional)
Region
- Northern Colorado
- Southern Colorado
- Metro Denver
- Wyoming
- Nebraska
Clinic Locations
To add more locations, click the (plus) symbol. Paste location link from location page
Clinic Name Link to Clinic Location Page (if available)
Education
To add more education, click the (plus) symbol.
Degree Name of School Year of Graduation
Philosophy of Care
Clinical Interests
Research Interests
Any other About me information (family, etc.)
Certifications (if applicable)
Why choose UCHealth?
(if asked during onboarding)
Video
(if yes, paste YouTube/Vimeo link)
Medical Specialties
- Addiction Psychiatry
- Endocrine System (Hormones) - Endocrine Cancer (Parathyroid, Adrenal, Carcinoid)
- Neurology
- Adult Cardiothoracic Anesthesiology
- Endocrine System (Hormones) - Pancreatitis
- Neuromuscular Medicine
- Adult Reconstructive Orthopedic Surgery
- Endocrine System (Hormones) - Thyroid Cancer
- Neuropathology
- Adult Strabismus
- Endocrine System (Hormones) - Thyroid Disease
- Neuroradiology
- Advanced Heart Failure
- Endocrinology
- Neurotology
- Aerospace Medicine
- Endocrinology, Diabetes and Metabolism
- Nuclear Radiology
- AIDS - AIDS
- Endovascular Surgical Neuroradiology
- Nutrition and Metabolism - Nutrition
- AIDS - HIV Disease
- Environmental Health
- Nutrition and Metabolism - Obesity
- AIDS - Immunization
- Epilepsy
- Nutrition and Metabolism - Weight Loss and Dieting
- Allergy and Immunology
- Eyes and Vision
- Nutrition and Metabolism - Weight Loss Surgery
- Anatomic and Clinical Pathology
- Eyes and Vision - Cataract
- Obstetrics and Gynecology
- Anesthesiology
- Eyes and Vision - Cataract Extraction
- Occupational Medicine
- Bariatric Surgery
- Eyes and Vision - Diabetic Eye Disease
- Ophthalmology
- Blood / Lymphatic System
- Eyes and Vision - Dry Eyes
- Orthopedic Hand Surgery
- Blood / Lymphatic System - Bleeding Disorders
- Eyes and Vision - Eye Disease
- Orthopedic Spine Surgery
- Blood / Lymphatic System - Blood Disorders
- Eyes and Vision - Glaucoma
- Orthopedic Sports Medicine Surgery
- Blood / Lymphatic System - Clotting Disorders
- Eyes and Vision - Pediatric Ophthalmology
- Orthopedic Surgery
- Blood Banking / Transfusion Medicine Pathology
- Eyes and Vision - Uveitis and Ocular Immunology
- Orthopedic Trauma Surgery
- Bones, Joints and Muscles
- Family Medicine
- Otolaryngology
- Brain and Nervous System
- Female Pelvic Medicine and Reconstructive Surgery - OB/GYN
- Pain Medicine
- Brain and Nervous System - Alzheimer's Disease
- Food, Nutrition and Metabolism
- Pathology
- Brain and Nervous System - Brain Abscess
- Gastroenterology
- Pediatric Adolescent Medicine
- Brain and Nervous System - Brain Tumors
- Gastroenterology
- Pediatric Anesthesiology
- Brain and Nervous System - Deep Brain Stimulation
- Genetic Conditions and Testing
- Pediatric Cardiology
- Brain and Nervous System - Epilepsy
- Geriatric Family Medicine
- Pediatric Critical Care Medicine
- Brain and Nervous System - General Neurosurgery
- Geriatric Internal Medicine
- Pediatric Emergency Medicine
- Brain and Nervous System - Meningitis
- Geriatric Medicine
- Pediatric Gastroenterology
- Brain and Nervous System - Migraine
- Gynecologic Oncology
- Pediatric Hematology / Oncology
- Brain and Nervous System - Movement Disorders
- Hair and Nails
- Pediatric Infectious Diseases
- Brain and Nervous System - Multiple Sclerosis
- Hand Plastic Surgery
- Pediatric Internal Medicine
- Brain and Nervous System - Neuromuscular Diseases
- Hand Surgery
- Pediatric Neonatal-Perinatal Medicine
- Brain and Nervous System - Neurovascular Conditions
- Head and Neck Otolaryngology Plastic Surgery
- Pediatric Orthopedic Surgery
- Brain and Nervous System - Parkinson's Disease
- Heart and Circulation
- Pediatric Otolaryngology
- Brain and Nervous System - Peripheral Nerve Repair
- Heart and Circulation - Adult Congenital Heart Disease
- Pediatric Pulmonology
- Brain and Nervous System - Sleep Apnea
- Heart and Circulation - Aneurysms
- Pediatric Radiology
- Brain and Nervous System - Sleep Disorders
- Heart and Circulation - Angina
- Pediatric Surgery
- Brain and Nervous System - Spine Diseases and Conditions
- Heart and Circulation - Angioplasty
- Pediatric Transplant Hepatology
- Brain and Nervous System - Stroke
- Heart and Circulation - Arrhythmia
- Pediatric Urology
- Brain and Nervous System - Trauma / Nerve Injuries
- Heart and Circulation - Cardiomyopathy
- Pediatrics
- Brain and Nervous System - Traumatic and Acquired Brain Injuries
- Heart and Circulation - Circulatory Disorders
- Physical Medicine
- Brain and Nervous System - Trigeminal Neuralgia
- Heart and Circulation - Congenital Heart Disease
- Physical Medicine and Rehabilitation
- Breast Specialist
- Heart and Circulation - Coronary Disease
- Physical Medicine and Rehabilitation - Pain Medicine
- Cancer / Oncology
- Heart and Circulation - Heart Attack
- Physical Medicine and Rehabilitation - Sports Medicine
- Cancers
- Heart and Circulation - Heart Diseases
- Plastic Surgery
- Cancers - Anal Cancer
- Heart and Circulation - Heart Diseases - Prevention
- Podiatry
- Cancers - Bladder Cancer
- Heart and Circulation - Heart Failure
- Poisoning
- Cancers - Blood and Marrow Transplant
- Heart and Circulation - Heart Valve Diseases
- Pregnancy and Reproduction
- Cancers - Brain Cancer
- Heart and Circulation - High Blood Pressure
- Pregnancy and Reproduction - Childbirth
- Cancers - Breast Cancer
- Heart and Circulation - Interventional Cardiology
- Pregnancy and Reproduction - Endocrine Disorders
- Cancers - Cancer Medicine
- Heart and Circulation - Peripheral Artery Disease
- Pregnancy and Reproduction - High-Risk Pregnancy
- Cancers - Cancer Prevention
- Heart and Circulation - TAVR
- Pregnancy and Reproduction - Infertility / Fertility Treatment
- Cancers - Cancer Radiation Therapy
- Hematology and Oncology
- Pregnancy and Reproduction - Maternal and Fetal Health
- Cancers - Cancer Surgery
- Hematology Pathology
- Pregnancy and Reproduction - Neonatal Intensive Care
- Cancers - Cervical Cancer
- Hospice and Palliative Family Medicine
- Pregnancy and Reproduction - Pregnancy
- Cancers - Chemotherapy
- Hospice and Palliative Internal Medicine
- Pregnancy and Reproduction - Prenatal Care
- Cancers - Colorectal Cancer
- Hospital Medicine
- Pregnancy and Reproduction - Prenatal Testing
- Cancers - Gastroenterologic Cancer (Colon, Stomach, Esophageal, Liver)
- Immune System
- Preventive Medicine
- Cancers - Gynecologic Cancer
- Immune System - Allergies
- Primary - Clinical Neurophysiology
- Cancers - Head and Neck Cancer
- Immune System - Autoimmune Disorders
- Primary Care
- Cancers - Kidney Cancer
- Immune System - Immunodeficiency
- Psychiatry
- Cancers - Leukemia (Adult Acute)
- Immune System - Rheumatoid Arthritis
- Psychiatry and Neurology
- Cancers - Leukemia (Adult Chronic)
- Immune System - Sinusitis
- Psychology
- Cancers - Living with Cancer
- Immune System - Urticaria (Hives)
- Pulmonary Disease
- Cancers - Lung Cancer
- Immune System/AIDS - AIDS
- Pulmonary Disease and Critical Care Medicine
- Cancers - Lymphoma
- Immune System/AIDS - HIV Disease
- Radiation Oncology
- Cancers - Melanoma
- Immune System/AIDS - Immunization
- Radiology
- Cancers - Myeloma
- Infections
- Radiology - Abdominal Imaging
- Cancers - Ovarian Cancer
- Infections - Bacterial Infections
- Radiology - Musculoskeletal Imaging
- Cancers - Pancreatic Cancer
- Infections - Fungal Infections
- Rehabilitation - Spinal Cord Injury Medicine
- Cancers - Prostate Cancer
- Infections - Influenza
- Rehabilitation Therapy
- Cancers - Radiation Therapy
- Infections - Pneumonia
- Rehabilitation Therapy - Inpatient Rehabilitation
- Cancers - Sarcoma
- Infections - Sexually Transmitted Diseases
- Rehabilitation Therapy - Occupational Therapy
- Cancers - Skin Cancer
- Infections - Viral Infections
- Rehabilitation Therapy - Physical Therapy
- Cancers - Testicular Cancer
- Infectious Disease
- Rehabilitation Therapy - Speech Therapy
- Cancers - Urologic Cancer
- Injuries and Wounds
- Reproductive Endocrinology / Infertility
- Cancers - Uterine Cancer
- Injuries and Wounds - Wounds
- Rheumatology
- Cardiology
- Internal Medicine
- Rhinology
- Cardiovascular Disease
- Interventional Cardiology
- Sacroiliac Joint
- Child and Adolescent Psychiatry
- Joints and Muscles - Arthritis
- Seniors Health
- Child and Teen Health
- Joints and Muscles - Back Pain
- Skin, Hair, Biopsies and Excisions
- Child and Teen Health - Children's Health
- Joints and Muscles - Carpal Tunnel Syndrome
- Sleep Medicine
- Child and Teen Health - Infant and Toddler Health
- Joints and Muscles - Fibromyalgia
- Sleep Medicine - Psychiatry and Neurology
- Child and Teen Health - Parenting
- Joints and Muscles - Foot and Ankle Injuries and Disorders
- Spinal Deformity
- Child and Teen Health - Pediatric Diseases and Conditions
- Joints and Muscles - Fractures
- Sports Family Medicine
- Child and Teen Health - Teen Health
- Joints and Muscles - Hand
- Stress Management
- Child Neurology
- Joints and Muscles - Hip Injuries and Disorders
- Substance Abuse - Smoking Cessation
- Clinical Cardiac Electrophysiology
- Joints and Muscles - Knee Injuries and Disorders
- Surgery
- Clinical Genetics (MD)
- Joints and Muscles - Leg Injuries and Disorders
- Surgery - Adult Cardiac Surgery
- Colon and Rectal Surgery
- Joints and Muscles - Neck Disorders and Injuries
- Surgery - Adult General Thoracic Surgery
- Complementary and Alternative Therapies
- Joints and Muscles - Osteoporosis
- Surgery - Cardiothoracic Surgery
- Complex General Surgical Oncology
- Joints and Muscles - Scoliosis
- Surgery - Eye and/or Orbital Surgery
- Congenital Cardiac Surgery
- Joints and Muscles - Shoulder Injuries and Disorders
- Surgery - Hand Surgery
- Critical Care
- Joints and Muscles - Spine Injuries
- Surgery - Infectious Lung Disease
- Critical Care Medicine
- Joints and Muscles - Sprains and Strains
- Surgery - Laparoscopic Surgery
- Cytopathology Pathology
- Kidneys and Urinary System
- Surgery - Major Liver Surgery (Hepatobiliary)
- Dentistry - General
- Kidneys and Urinary System - Bladder Disease
- Surgery - Minimally Invasive Thoracic Surgery
- Dentistry - Oral Surgery
- Kidneys and Urinary System - Incontinence
- Surgery - Open Heart Surgery
- Dermatology
- Kidneys and Urinary System - Interstitial Nephritis
- Surgery - Robotic Surgery
- Dermatology
- Kidneys and Urinary System - Kidney Disease
- Surgery - Trauma and Acute Care
- Dermatology - Dermatopathology
- Kidneys and Urinary System - Kidney Failure
- Surgery - Urologic Surgery
- Diabetes and Metabolism
- Kidneys and Urinary System - Kidney Infection
- Surgery - Vascular Surgery
- Diagnostic Radiology
- Kidneys and Urinary System - Kidney Stones
- Surgery - Weight Loss Surgery
- Digestive System
- Kidneys and Urinary System - Nephropathy (Nephrosis)
- Symptoms and Manifestations
- Digestive System - Biliary Surgery
- Kidneys and Urinary System - Preeclampsia
- Symptoms and Manifestations - Abdominal Pain
- Digestive System - Colonoscopy
- Kidneys and Urinary System - Prostate Disease
- Symptoms and Manifestations - Chronic Fatigue
- Digestive System - Gastroenterology (Stomach, Bowel, General GI Problems)
- Kidneys and Urinary System - Proteinuria
- Symptoms and Manifestations - Cough
- Digestive System - Gastrointestinal Surgery
- Kidneys and Urinary System - Reconstructive Pelvic Surgery
- Symptoms and Manifestations - Dizziness and Vertigo
- Digestive System - Hemorrhoids
- Kidneys and Urinary System - Reconstructive Urology
- Symptoms and Manifestations - Fever
- Digestive System - Hepatology (Liver Disorders)
- Lungs and Breathing
- Symptoms and Manifestations - Headache
- Digestive System - Hernia
- Lungs and Breathing - Asthma
- Symptoms and Manifestations - Heartburn
- Digestive System - Inflammatory Bowel Disease (IBD): Crohn's disease, ulcerative colitis, microscopic colitis
- Lungs and Breathing - Granulomatous Lung Disease
- Symptoms and Manifestations - Pain
- Digestive System - Irritable Bowel Syndrome (IBS)
- Lungs and Breathing - Interstitial Lung Disease
- Thoracic and Cardiac Surgery
- Digestive System - Motility disorders
- Lungs and Breathing - Lung Disease
- Toxicology
- Digestive System - Surgical Endoscopy
- Lungs and Breathing - Pulmonary Disorders
- Transplant Cardiology
- Digestive System - Therapeutic Endoscopy
- Lungs and Breathing - Pulmonary Hypertension
- Transplant Hepatology
- Ear, Nose, and Throat - Dysphagia (Trouble Swallowing)
- Maternal and Fetal Medicine
- Trauma and Acute Care Surgery
- Ear, Nose, and Throat - Ear Infection
- Medical Genetics
- Travel Medicine
- Ear, Nose, and Throat - Head and Neck Tumors
- Medical Oncology
- Urgent Care
- Ear, Nose, and Throat - Hearing Loss
- Men's Health
- Urinary System - Nephrotic Syndrome
- Ear, Nose, and Throat - Hoarseness
- Men's Health - Infertility and Reproductive Medicine
- Urologic Oncology
- Ear, Nose, and Throat - Nasal Polyps
- Men's Health - Prostate Conditions
- Urology
- Ear, Nose, and Throat - Professional Voice Problems
- Mental Health and Behavior
- Vascular and Interventional Radiology
- Ear, Nose, and Throat - Salivary Gland Diseases/Stones
- Mental Health and Behavior - Anxiety
- Vascular Malformations
- Ear, Nose, and Throat - Sinus Tumors
- Mental Health and Behavior - Attention Deficit Disorder with Hyperactivity
- Vascular Neurology
- Ear, Nose, and Throat - Skull Base Tumors
- Mental Health and Behavior - Bereavement
- Vascular Surgery
- Ear, Nose, and Throat - Smell and Taste Disorders
- Mental Health and Behavior - Bipolar Disorder
- Wellness and Lifestyle
- Ear, Nose, and Throat - Snoring
- Mental Health and Behavior - Depression
- Wellness and Lifestyle - Exercise and Physical Fitness
- Ear, Nose, and Throat - Tinnitus
- Mental Health and Behavior - Eating Disorders
- Wellness and Lifestyle - Occupational Health
- Ear, Nose, and Throat - Tonsilitis
- Mental Health and Behavior - Obsessive-Compulsive Disorder
- Women's Health
- Ear, Nose, and Throat (ENT)
- Mental Health and Behavior - Panic Disorder
- Women's Health - Adolescent Reproductive Health - Adolescent Gynecology
- Emergency Care
- Mental Health and Behavior - Post-Traumatic Stress Disorder
- Women's Health - Breast Feeding
- Emergency Medicine
- Mental Health and Behavior - Seasonal Affective Disorder
- Women's Health - Contraception
- Endocrine System - Adrenal Diseases
- Mental Health and Behavior - Stress
- Women's Health - Endometriosis
- Endocrine System - Lipidoses
- Molecular Genetic Pathology
- Women's Health - Fecal Incontinence
- Endocrine System - Osteoporosis
- Musculoskeletal Oncology Orthopedic Surgery
- Women's Health - Gynecologic and Obstetric Infections
- Endocrine System (Hormones)
- Nephrology
- Women's Health - Hormone Replacement Therapy
- Endocrine System (Hormones) - Adult Type 1 Diabetes
- Neurological Surgery
- Women's Health - Menopause
- Endocrine System (Hormones) - Adult Type 2 Diabetes
- Neurological Services
- Women's Health - Pelvic Organ Prolapse
Need to remove information?
Need to completely remove information on a profile? Fill out these items to identify which field on the profile that needs information removed. Please provide additional instructions for removal.
Removal List
Field Additional Instructions
Submitter Name*
Submitter Email
Name
This field is for validation purposes and should be left unchanged.

Save and Continue Later

Provider profile request

Add a provider

Edit a provider

Remove a provider

Need to remove information?