Here you will find the most used forms at Northwest Health Services. Save time and fill out your forms ahead of time.
We look forward to caring for you!
YOU MAY QUALIFY FOR ANY OF OUR PROGRAMS:
Fill out this form to register as a Northwest Health Services' patient. We'll need patient, billing, insurance and household information.
Northwest Health Services Discount Program is based on a sliding fee which includes medical, dental, behavioral health & pharmacy services. Apply today!
DISCOUNT PROGRAM INFO
DISCOUNT PROGRAM APPLICATION
This notice describes how medical information about you may be used and disclosed (shared with others) and how you can get access to this information.
NOTICE OF PRIVACY PRACTICES
SIGN OFF FORM ONLY
This form tells us which family members and friends have your permission to have your health information
WHO CAN HAVE YOUR HEALTH INFORMATION
Review your rights as a patient of Northwest Health