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Kiowa County Memorial Hospital
  • Home
  • Services
    • Emergency Services
    • Laboratory
    • Radiology
    • Physical Therapy
    • Rural Health Clinic
    • Swing Bed & Acute Care
    • Specialty Clinics
    • Conference Center
  • Providers
  • Locations
  • About Us
    • Mission & Values
    • Our Green Initiative
    • The Tornado
    • KCMH Boards
  • Health Needs Assesment
  • Patient Rights
  • KCMH Patient Portal
  • Financial Assistance
  • Standard Charges
  • Employment Opportunities
  • Records Request
  • Health Resources
    • Educational Videos
    • Asbestos.com
    • Mesothelioma.net
  • COVID-19 Self Assessment
  • More
    • Home
    • Services
      • Emergency Services
      • Laboratory
      • Radiology
      • Physical Therapy
      • Rural Health Clinic
      • Swing Bed & Acute Care
      • Specialty Clinics
      • Conference Center
    • Providers
    • Locations
    • About Us
      • Mission & Values
      • Our Green Initiative
      • The Tornado
      • KCMH Boards
    • Health Needs Assesment
    • Patient Rights
    • KCMH Patient Portal
    • Financial Assistance
    • Standard Charges
    • Employment Opportunities
    • Records Request
    • Health Resources
      • Educational Videos
      • Asbestos.com
      • Mesothelioma.net
    • COVID-19 Self Assessment
Kiowa County Memorial Hospital

EN

  • Home
  • Services
  • Providers
  • Locations
  • About Us
  • Health Needs Assesment
  • Patient Rights
  • KCMH Patient Portal
  • Financial Assistance
  • Standard Charges
  • Employment Opportunities
  • Records Request
  • Health Resources
  • COVID-19 Self Assessment

KCMH Financial Assistance

If you would like to apply for financial assistance, please complete the form below.  Once completed, contact Misty Kenton at Kiowa County Memorial Hospital business office (620)723-3341, or by email at mkenton@kcmh.net. 

2021 Financial Assistance Application (pdf)

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2021 Financial Assistance Application Spanish (pdf)

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Financial Assistance Program and Collection Policy - 2021 Update (pdf)

Download

2021 Plain Language Summary (pdf)

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Solicitud de Asistencia Financiera (pdf)

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2021 Programa de asistencia financiera y política de cobranza (pdf)

Download

2021 Plain Language Summary Spanish (pdf)

Download

FAP Appendix A - Updated January 2021 (pdf)

Download

APPENDIX B 2021 (pdf)

Download

APPENDIX C 2021 (pdf)

Download

APÉNDICE C (pdf)

Download

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 program.intake@usda.gov 


  • Health Needs Assesment
  • Patient Rights
  • KCMH Patient Portal
  • Financial Assistance
  • Standard Charges
  • Employment Opportunities
  • Records Request
  • COVID-19 Self Assessment
  • No Surprise Billing

KCMH Board Meeting

The next regular board meeting will be held on Friday, May 27, 2022 at 9:30 am.

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