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Patient Registration

Complete your paperwork ahead of time to make check-in fast and easy.

At Graham County Hospital, we want your visit to be as smooth as possible. To help speed up the check-in process, we encourage all patients to complete the necessary registration forms before arriving for their appointment or scheduled procedure.

Please bring your completed forms, a valid photo ID, and your insurance card to the Registration Office, located at the hospital’s main entrance.

Patient Forms:

The following forms are for all new patients or returning patients with updated information. Please print, complete, and bring these to your appointment.

1. Sports Physical Form

Provides required health information and clearance for students participating in school or organized sports activities.

Download SPORTS PHYSICAL Form

2. Department of Transportation (DOT) Form

Provides the necessary health examination documentation required for compliance with Department of Transportation regulations for commercial drivers.

Download DOT FORM

3. Medical Records Release Form

Authorizes the release of your medical records to a designated individual or organization for continuity of care or other approved purposes.

DOWNLOAD MEDICAL RECORDS RELEASE FORM

Additional Form (as needed):

Depending on your visit type, you may also be asked to complete:

Pediatric Registration Form (for patients under 18)
Authorization for Release of Medical Records
Advance Directive (Living Will / Healthcare Proxy)
Language Assistance Request Form

Where to Submit Forms:

Completed forms can be:

Dropped off at the Registration Desk (Main Entrance)
Faxed to: (785) 421-2034
Mailed to:
Graham County Hospital
Registration Department
304 W Prout St
Hill City, KS 67642