Patient Documents

Practices & Policies Documents

Patient Rights and Responsibilities, Anti-discrimination and Language Services, HIPAA Practices, and Grievance Procedures – English (161KB PDF)

Patient Rights and Responsibilities, Anti-discrimination and Language Services, HIPAA Practices, and Grievance Procedures – Spanish (145KB PDF)

Charity Care – Financial Relief Policy (132KB PDF)

Financial Affidavit Application (165KB PDF)

Forms (PDFs)

Medical Records Release Authorization Form (255KB PDF)

Language Services

Limited English Proficiency Language Services (267KB PDF)