If you would like to apply for financial assistance, please complete the form below. Once completed, contact Kiowa County Memorial Hospital business office (620)723-3341, or by email at firstname.lastname@example.org
Financial Assistance Appliction (docx)Download
Financial Assistance Application Spanish (docx)Download
2023 Plain Language Summary (docx)Download
2023 Plain Language Summary Spanish (docx)Download
APPENDIX B 2023 (docx)Download
APPENDIX B 2023 Spanish (docx)Download
APPENDIX C 2023 (docx)Download
APPENDIX C 2023 Spanish (docx)Download
Kiowa County Memorial Hospital is pleased to announce that we have partnered with PayZen
PayZen offers affordable payment options, so you can now pay your bill over time with no interest or fees. Enrollment is fast, easy, and automated, with customized payment plans that work for your budget.
If you have an outstanding balance greater than $250 and would like to enroll in a payment plan, sign up at kcmh.payzen.com
Copyright © 2022 Kiowa County Memorial Hospital - All Rights Reserved.
Notice of Privacy Practices. This institution is an equal opportunity provider and employer.
If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at email@example.com
The next KCMH Board will be held on October 27th, 2023, at 9 a.m. in the administrative conference room.