Please download and fill out this form. Once completed, you may scan it back in and email us at or mail/drop off in person to 740 gunnison Ave. grand junction, co 81501

If you have questions about this, please contact Direct Services Manager, Valorie Castle at 970-241-0315 or

Grand Junction Location
740 Gunnison Ave.
Grand Junction, CO 81501

OFFICE: 970-241.0315
TOLL FREE: 800-613-2271
FAX: 970-245-3341
Glenwood Springs Location
823 Blake Street, STE 102
Glenwood Springs, CO 81601
OFFICE: 970-718-5155
FAX: 970-340-8845
Montrose location
245 South Cascade, STE B
Montrose, CO 81401
OFFICE: 970-822-7010
FAX: 970-822-7011

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