Please complete the form below to submit a Care Coordination referral. Referrals may be submitted by anyone. Care Coordination is a free benefit available to Health First Colorado members. If you need assistance completing this form, please call our Care Coordination team at 888-502-4190.

  1. Referral Source
  2. Member Information
  3. Accessibility & Communication Needs
  4. Reason for Referral
  5. Alternate Contact
  6. Review
  7. Submit