Help Test the Health Care Provider Portal for Colorado's FAMLI Division

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In late Summer of 2023, health care providers will be asked to register with the FAMLI Division to help make sure things go smoothly when Coloradans start applying for paid family and medical leave insurance benefits in 2024. Registering directly in the system will allow health care providers to provide an elevated patient experience by supporting them – and their families – when a serious health condition prevents them from working by getting rid of excess paperwork.

We're offering a preview of the portal to learn more about how health care providers (and their staff) intend to use the system before we launch.

**Please only fill out this form if you are a health care provider or have a role in direct patient care.**

Email *

Name *

Company/Organization/Employer Name

Which of the following best describes your role in healthcare. *

I provide direct patient care: I'm licensed, certified, or registered under Federal or Colorado law to provide medical or emergency services. (i.e. Physicians, doctors, nurses, midwives, emergency room personnel etc.)

I am in insurance and have a role in approving insurance claims.

My role is in office administration: greeting patients, setting appointments etc.

Other:

Required

What is the specialty of your practice (i.e. Primary Care, Obstetrics and Gynecology, Pediatrics, Behavior Health, Oncology, Orthopedics, Cardiology etc.)

What best describes the community where you see patients?

Urban

Suburban

Rural

Other:

Clear selection

How likely are you to register in FAMLI's online health care provider portal in order to verify your patients' claims for paid family leave benefits? *

Very Unlikely (I do not intend to register or use the online portal)

Very Likely (I look forward to using the online portal to better serve my patients!)

What is your preferred way to verify existing serious health condition forms and/or requests for medical leave? *

I prefer to sign paperwork and leave it up to my patients to file properly.

I prefer a digital option that can be completed and verified all online.

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