Free Consultation

Get Free Help Today

Complete the intake form below to request a free, confidential consultation with one of our certified patient advocates. All services are provided at no cost. Most clients receive a callback within two business days.

Patient Advocacy Intake Form

All information is kept strictly confidential. Fields marked with * are required.

First Name *

Last Name *

Email Address *

Phone Number *

Current Insurance Type *

What Do You Need Help With? *

How Urgent Is Your Situation?

Please Describe Your Situation

I understand that Common Sense Healthcare provides advocacy and educational services, not medical or legal advice. I consent to be contacted regarding my inquiry. All information will be kept confidential per the organization's privacy policy.

What to Expect

Submit your intake form with as much detail as possible about your situation.
A certified advocate reviews your case and contacts you within two business days.
You will receive a 60-minute initial consultation by phone or in-person at our Denver office.
Your advocate develops a personalized action plan and begins working on your behalf.
Follow-up support continues until your issue is resolved to your satisfaction.

Urgent Situations

If you are facing an imminent appeal deadline, active collections action, or a treatment delay that could affect your health, please call us directly for expedited assistance:

(720) 555-0461

Mon–Thu: 9 AM – 6 PM • Fri: 9 AM – 1 PM

Get Free Help Today

Patient Advocacy Intake Form

Request Submitted Successfully

What to Expect

Urgent Situations