CONSENT FORMS

IMAGE/RECORDING RELEASE FORM


If you have been asked to complete a consent form allowing The Richland Hospital and Clinics and/or the Richland Hospital Foundation to use your name, image, quote, and other identifying information for our marketing purposes, please choose from the options below. (complete online or download pdf)

HIPAA RELEASE FORM


If you have been photographed or videotaped while a patient at The Richland Hospital and Clinics and have been asked to complete a HIPAA Release form, please choose from the options below. (complete online or download pdf)

FROM BIRTH TO SENIOR CARE

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PRIMARY & SPECIALIST CARE

Richland Center - Muscoda - Spring Green

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