Patient Forms & Notices

Patient Forms & Notices

All our hospital’s patient forms and notices are collected here in PDF form. These are the policies you will be asked to read before or after receiving medical treatment at our hospital. You will be asked to complete the forms after your visit here. 


Financial Assistance

Patient Notices

Release Form

When you complete and sign this form, you give us permission to share your medical information with a specific healthcare provider.

mlkch staff member helping guest filling out form

Find important information related to your privacy, our non-discrimination policy, and giving other people permission to see your health records.

HIPAA Notice of Privacy Practices

Patient Rights & Responsibilities

Non-Discrimination Statement

Notice of Charity Care & Fair Pricing

Medical Records Release Form