Sign Up for Services

Broomfield Public Health Programs

You can use the below form to self-refer or refer another person to certain Public Health and Environment programs. Broomfield Public Health and Environment will respond to the request within two (2) business days. Learn more about the programs below, or by visiting the individual webpages for each program with the left side navigation (desktop) or bottom navigation (mobile).

Family Connects

Family Connects offers a nurse visit to Broomfield families with a newborn who has been delivered at a Boulder County hospital. A nurse visits your home from three to twelve weeks after birth to check on the parent, baby and the whole family. There is no additional cost to you. To enroll, visit https://familyconnectscolorado.org/schedule-your-visit/.

HCP: Children and Youth with Special Health Care Needs

Broomfield’s HCP Program provides information and resources for children and youth with special health care needs from birth to 21 years of age. The program is free to anyone needing help to address a child’s behavioral, developmental, medical, and/or social needs. To enroll, complete the form below. 

Immunization Clinic

The Broomfield Immunization clinic provides up-to-date and reliable information about all recommended vaccines, including COVID-19. Public health nurses administer vaccines to children and adults regardless of age or where you live. Low or no cost vaccines are available to those who have Medicaid, who are uninsured, underinsured or paying out of pocket.  We do not accept or bill private insurance. To enroll, complete the form below. 

Reproductive Health Clinic

The Reproductive Health Clinic provides reproductive health and family planning services.  Services are confidential, teen-friendly, LGBTQ+ friendly, and low cost. Services are open to anyone regardless of county of residency.

Services include physical assessment, pregnancy testing, sexually transmitted infections (STI) testing, pelvic exams, breast exams, Papanicolaou (PAP) smears, colposcopy and Family Planning services. Minimal fee to no cost services available on a sliding fee scale. No one will be denied services because of their inability to pay. To enroll, complete the form below. 

WIC (Supplemental Nutrition Program for Women, Infants, and Children)

WIC provides free nutritious foods, nutrition education, access to a dietitian, breastfeeding support, and healthcare referrals. For more information and to enroll in WIC, visit Broomfield.org/WIC.

Instructions for Referral Form

1. Contact Information - Please enter your own information, even if you are referring your child for services.
2. “What programs would you like to participate in”?
   1. If you are interested in the Immunization Clinic, please select “Screenings and Immunizations.”
   2. If you are interested in the Reproductive Health Clinic, please select “Specialty Care” or “Screenings and Immunizations.”
   3. If you are interested in the HCP program, please select "HCP: A Program for Children and Youth with Special Health Care Needs."
3. “Please describe your request for services”.
   1. Please list all program names you want to be enrolled in here.