Designated Provider Letter Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *We are sorry to learn that you have been injured. In order to be sure you receive the care you need, we are filing a claim with our workers’ compensation insurance carrier, biBERK. BiBERK will contact you regarding your claim and additional information very soon. In the meantime, you should see one of the medical providers we have selected to treat our injured employees. These medical providers specialize in on-the-job injuries and we want you to have the best possible care. Click below to acknowledge. *AcknowledgedProvider List – Provider: MEDICINE FOR BUSINESS AND INDUSTRY LLC, 205 S MAIN, STE C, LONGMONT, CO 80501. Phone #: 303.702.1612. Click below to acknowledge. *AcknowledgedProvider: CONCENTRA MEDICAL CENTERS-CO–DOWNTOWN DENVER, 1730 BLAKE ST, STE 100, DENVER, CO 80202. Phone #: 303.296.2273. Click below to acknowledge. *AcknowledgedProvider: CONCENTRA MEDICAL CENTERS-CO-THORNTON, 500 E 84TH AVE, STE B14, THORNTON, CO 80229. Phone #: 303.287.7070. Click below to acknowledge. *AcknowledgedProvider: CONCENTRA MEDICAL CENTERS-CO-FT COLLINS, 620 S LEMAY AVENUE, FORT COLLINS, CO 80524. Phone #: 970.221.5811. Click below to acknowledge. *AcknowledgedPlease contact one of these medical providers to be seen as soon as possible. After your first appointment, please follow up with HR so we can review your medical status and work capabilities. Our workers’ compensation insurance company is biBERK, P.O. Box 113247, Stamford, CT 06911. Phone: 844.472.0967. Our goal is to ensure that you get the care you need to recover quickly and return to work as soon as possible. Click below to acknowledge. *AcknowledgedEmployer Representative for Workers’ Compensation: Krissy Kaplan, HR Director, Craft Health, 1650 38th Street, Suite 101E, Boulder, CO 80301. Phone: 720-274-5974 x202. Click below to acknowledge. *AcknowledgedI understand that by typing my name below and clicking on "Submit", I am electronically signing this document and am certifying that the above information is true and correct. A copy of this form will be emailed to you and HR. *Date * Submit