Below you will find a library of helpful forms. Each of these is available in Adobe Acrobat PDF format. If you need the free Adobe Acrobat Reader software, you can access it here: https://get.adobe.com/reader/

Financial Forms

Medical Forms

Scholarship Application

Find My Cost Worksheet
Financial Assistance Policy
Financial Assistance Application
Employee Verification Form
Provider Listing
Plain Language Summary
Authorization to Disclose Protected Health Information – Laconia
Authorization to Disclose Protected Health Information – Franklin
Patient Requests To Amend Protected Health Information – Laconia
Patient Requests To Amend Protected Health Information – Franklin
2020 Auxiliary Scholarship Application