Submit Documents Securely Online
Submit Documents Securely Online
Please use the form below to securely upload documents related to your services with WellPower. If you are submitting documents on behalf of a person in services, please also provide your information in the designated fields below.
Please allow the Health Information Systems Management (“HISM”) team approximately 2-3 business days from time of receipt to review the documents submitted. If you are submitting documents related to WellPower’s Financial Assistance Program, please also allow the finance team 2-3 business days to review the documents submitted.
Acceptable file formats include: .png, .gif, .jpg, .pdf
Examples of types of documents to submit here:
- State-Issued ID, Driver’s License, or Passport
- Health Insurance Card
- Proof of income (W-2, Paystub, etc.)
- Proof of legal guardianship/medical decision-making authority
- Birth/Death Certificate
- Marriage/Divorce Certificates
- WellPower forms that you completed and need to submit back to us
- Other documents we requested from you
Documents and images that cannot be easily read or are unrelated to the list above may not be accepted.
If you have questions about submitting documents to WellPower using this page, please contact the HISM team at (303) 504-6510 or at HISM@wellpower.org.
Please note: Fields marked with an asterisk (*) are required and must be filled in before you can add files for upload.
We take your privacy seriously. All submissions through this webpage are secured by Citrix ShareFile (https://www.sharefile.com). Questions? Contact the HISM team at (303) 504-6510 or at HISM@wellpower.org.