Patient Forms & Policies
Day Kimball Hospital Forms & Policies
Inpatient Admissions Packet
Day Kimball Hospital Authorization to Release Medical Records Form
This form must be presented at the Day Kimball Hospital Medical Records Office along with proof of identification in order to obtain records.
Day Kimball Medical Group (physician practices) Forms & Policies
No Show Policy
Notice of Privacy Practices
Receipt of Privacy Notice
Consent for Basic Treatment
Authorization for Release of Information
Permission to Share
Day Kimball Healthcare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, are deaf or hard of hearing, language assistance services are provided free of charge. Call (860) 928-6541 ext. 2342 or ext. 2229; for TTY, dial 711 and ask to be connected to (860) 928-6541 ext. 2342 or ext. 2229.