For your convenience, a number of forms are available here for download.
ADVANCED DIRECTIVES
An advance directive is a written statement that documents your healthcare decisions or appoints another person to make decisions on your behalf. Advance directives include living wills and durable power of attorney for health care. Click here for frequently asked questions about advanced directives.
HEALTH INFORMATION ACCESS
Patients and their legal representatives generally have a right to their medical records. All you need to do is make a written request and in some cases, pay a fee. Please wait to sign this form until in the presence of a RCH employee as a witness.
Authorization for release of information
FINANCIAL ASSISTANCE
Financial assistance is available. Application for Financial Assistance
ORGAN DONATION
Organ and tissue donation after your death can play a vital role in improving the quality of life for others. Use the following link to register with the Iowa Organ Recovery System: Iowa Donor Network
PRIVACY POLICY
The confidentiality and security of your health information is our first priority. As a patient of Ringgold County Hospital, you can count on us to keep your health private and secure from any unauthorized access.
CODE of CONDUCT
This policy outlines responsibilities expected of all who work for Ringgold County Hospital.
TOBACCO-FREE CAMPUS
To protect the health of all patients, visitors and staff, the Ringgold County Hospital campus and its properties are tobacco free (including parking lots). Medication is available to patients to help curb a craving for tobacco.
