Please click on the links below to view KCMH patient policies. Kiowa County Memorial Hospital does not discriminate with regard to patient admissions, room assignment, patient services, or employment on the basis of race, color, national origin, gender, religion, disability or age. If assistance or communication aids for impaired hearing, vision, speech, or manual skills are needed, KCMH will make reasonable accommodations.
If you believe that Kiowa County Memorial Hospital, Greensburg Family Practice or Haviland Clinic has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Mary Sweet, Administrator, Kiowa County Memorial Hospital 721 W. Kansas Avenue, Greensburg, Kansas 67054 (620) 723-3341 msweet@kcmh.net . You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Mary Sweet, Administrator is available to help you.
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
If you would like to request copies of your medical records please download the file below and fill it out completely. You can then fax or mail the completed form and someone from our HIM department will contact you.
Fax Number: (620) 723-2195
Mail Form: Kiowa County Memorial Hospital
Attention HIM Department
721 W. Kansas Ave.
Greensburg, KS 67054
Copyright © 2018 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