| 15_kmc-itac_access_form_rev_8.30.2023.docx |
Supporting Departments |
PDF |
| 2023 CA-MED IRT Online Submission Forms |
Community |
Online |
| Agenda Request Form |
Governing Board |
PDF |
| agenda_request_form_2023.pdf |
Governing Board |
PDF |
| Board Agenda Request Packet Online Submission |
Governing Board |
Online |
| Bose Color by Numbers |
Diabetes |
PDF |
| Bo se liwhin |
Diabetes |
PDF |
| CA TB Risk Assessment |
Community |
PDF |
| Civil Disturbance Incident Report |
Administration |
PDF |
| Civil Disturbance Incident Report |
Quality |
PDF |
| Clone of KMC Online Housekeeping Work Order |
Supporting Departments |
Online |
| COA |
Fiscal |
PDF |
| Contact Us |
Community |
Online |
| Cost Center Change Form |
Fiscal |
PDF |
| Cost Centers |
Fiscal |
PDF |
| Cultural Path to Wellness Hupa Language Class Halloween Color by Numbers Online Submission |
Diabetes |
Online |
| DV/SA Intake Form |
|
PDF |
| Emergency Assistance Form 2021-2022 |
Assistance Programs |
PDF |
| Executive Summary Form |
Governing Board |
PDF |
| General Consent |
Patient Benefits |
PDF |
| Goals and SMART Objectives |
Administration |
PDF |
| HIPAA Consent Form |
Patient Benefits |
PDF |
| ICS Contact Information Sheet |
Supporting Departments |
PDF |
| IHS Notice of PP |
Community |
PDF |
| Incident Report Form |
Quality |
PDF |
| IRT Staff Member Contact Information Form |
Community |
PDF |
| ITAC Form Online Submission |
Supporting Departments |
Online |
| Kilwe-kyoh |
Diabetes |
PDF |
| Kitse qe che-nehaw n |
Diabetes |
PDF |
| KMC Annual Report Template |
Administration |
PDF |
| KMC Annual Report Template |
Administration |
PDF |
| KMC Background Form |
Community |
PDF |
| KMC Behavioral Health Credentialing Application |
Community |
PDF |
| KMC Board Agenda Request Form |
Governing Board |
PDF |
| KMC Budget Modification Form Online Submission |
Fiscal |
Online |
| KMC Confidentiality Form |
Community |
PDF |
| KMC Declination Hepatitis B |
Community |
PDF |
| KMC Declination Influenza Vaccine |
Community |
PDF |
| KMC Dental Staff Credentialing Application |
Community |
PDF |
| KMC Disciplinary Action Form |
Human Resources |
PDF |
| KMC Emergency Contact Form |
Community |
PDF |
| KMC Employee Evaluation Template |
Human Resources |
PDF |
| KMC Employee Handbook |
Human Resources |
PDF |
| KMC Employee Statement: Abuse |
Community |
PDF |
| KMC Employment and Volunteer Application |
Human Resources |
PDF |
| KMC Employment and Volunteer Application |
Human Resources |
PDF |
| KMC Employment and Volunteer Application |
Human Resources |
PDF |
| KMC Employment Application |
Community |
PDF |
| KMC Employment Background Check Form |
Human Resources |
PDF |
| KMC Energy Assistance Update for October 13.2022 |
Assistance Programs |
PDF |
