Forms

Our forms, everything you need to get started

Interested in getting started with LIV, or in applying for an open job position? Our forms page has everything you need, right here! We look forward to seeing how our services can best benefit you, your loved one, or your patient.

Referral Form

To get started, download one of our referral forms below, fill it out and return it to us through fax, 307-632-3298 (WY), or 970-372-6412 (CO), or email it to info@livhealth.org, and we’ll be in touch soon. You can also call our mainline 307-630-4729 (WY), 970-888-4070 (CO), and fill it out over the phone.

Employment Application

Interested in joining the LIV Health family? If you don’t see a specific position you’d like to apply for on our Join the Team page, you can download one of our application forms below and submit it to info@livhealth.org with your resume and cover letter.

Pricing Information

Have you wondered about the cost of LIV’s services? We take all types of insurance including Medicare, Medicaid, and most commercial insurances. We also offer a sliding fee discount program to all who are uninsured. We base program eligibility on a person’s ability to pay and will not discriminate on the basis of age, gender, race, sexual orientation, creed, religion, disability, or national origin. The Federal Poverty Guidelines will be used in determining eligibility. This policy will be reviewed on an annual basis and updated accordingly with the Federal Poverty Guidelines.

LIV Health Sliding Fee Scale - 2019
(click image to enlarge)

Download Printables

From Mother’s Day and Father’s cards to a Mental Health Tracker and the Feelings Wheel to a Final Wishes document, we have created several free printables for you to access and use. Please feel free to print, use, and share if you find them helpful!