Financial Assistance/Patient Forms
Financial Assistance Documents
- Community Care and Financial Assistance Policy
- Community Care Application
- Financial Assistance Policy (Community Care) Plain Language Summary
- Billing and Collection Policy
- Solicitud para Ayuda de Community Care
- POLÍTICA DE ATENCIÓN A LA COMUNIDAD Y ASISTENCIA FINANCIERA
- PÓLIZA DE FACTURACIÓN Y RECAUDACIÓN
Is My Provider Covered?
Click Here for a list of which providers are covered under our Financial Asistance Policy.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Please follow this link for a complete overview of a Health Care Power of Attorney.
En Español: Poder judicial para la atención médica
If you need assistance in completing this document you may contact: Reedsburg Area Medical Center at 608-524-6487 and ask to schedule an appointment with an Advance Care Planning Facilitator.
Release of Information
Reedsburg Area Medical Center is committed to protecting your privacy and confidentiality. Which is why we require patient or legal guardian authorization to release copies of your medical records. The Health Information Services Department maintains all RAMC patient healthcare records and reviews all requests for copies before processing.
Requested records are sent by mail and are not available by facsimile. The original records are kept at Reedsburg Area Medical Center. You may request copies of your records at any time.
How to Obtain Copies of Medical Records—In order to obtain copies of your medical records, you are required to fill out an "Authorization for Disclosure of Protected Health Information" form. You may request one by calling the Health Information Services Department at 608-524-6487, ext. 1800 or follow this link to access RAMC's Authorization for Disclosure of Protected Health Information.