| KMC Employment Background Check Form |
Human Resources |
PDF |
| KMC Energy Assistance Update for October 13.2022 |
Assistance Programs |
PDF |
| KMC Events Checklist and Permissions |
Administration |
Online |
| KMC Events Checklist and Permissions Form |
Administration |
PDF |
| KMC FY2022 Budget Modification Form |
Fiscal |
PDF |
| KMC General Consent |
Community |
PDF |
| KMC Governing Board Executive Summary Sheet |
Governing Board |
PDF |
| KMC Governing Board Executive Summary Sheet |
Governing Board |
PDF |
| KMC Health Statement Form |
Community |
PDF |
| KMC IRT ITAC Form |
Community |
PDF |
| KMC ITAC Form 2023 |
Supporting Departments |
PDF |
| KMC ITAC FORM 2023 |
Supporting Departments |
PDF |
| KMC Medical Privileges Request Form |
Community |
PDF |
| KMC Medical Staff Credentialing Application |
Community |
PDF |
| KMC Mission & Vision Statement |
Community |
PDF |
| KMC Notice of Privacy Practices |
HIM (MEDICAL RECORDS) |
PDF |
| KMC Notice of Privacy Practices |
Quality |
PDF |
| KMC Offboarding Online Submission Form |
|
Online |
| KMC Onboarding Online Submission Form |
|
Online |
| KMC Online Housekeeping Work Order |
Supporting Departments |
Online |
| KMC Online Maintenance Work Order Submission Form |
Supporting Departments |
Online |
| KMC Online Medication Refill Request |
Pharmacy |
Online |
| KMC Patient Comment Form |
Administration |
PDF |
| KMC Patient Comment Form Online Submission |
Administration |
Online |
| KMC Patient Handbook |
Quality |
PDF |
| KMC Personnel Policies |
Human Resources |
PDF |
| KMC Photo Release |
Community |
PDF |
| KMC PP Manual Receipt |
Community |
PDF |
| KMC Provider Initiation Sheet |
|
PDF |
| KMC ROI |
HIM (MEDICAL RECORDS) |
PDF |
| KMC Screening Matrix |
Human Resources |
PDF |
| KMC Semi Annual Report Template |
Administration |
PDF |
| KMC Semi Annual Report Template |
Administration |
PDF |
| KMC Vacant Position Form |
Human Resources |
PDF |
| KMC Work Order |
Supporting Departments |
PDF |
| KMC Work Order Form |
Administration |
PDF |
| LIHEAP/LIHWAP Application 2023-2024 |
Assistance Programs |
PDF |
| Medication Refill Clerk, Regular, F/T |
Human Resources |
Online |
| MMIP Intake Form |
|
PDF |
| MMIW & DV/SA Program: Intake Form Online Submission |
|
Online |
| New Patient Registration Page 1 |
Patient Benefits |
PDF |
| New Patient Registration Page 2 |
Patient Benefits |
PDF |
| New Patient Registration Paperwork Online Submission |
Patient Benefits |
Online |
| Online Employment Application Submission |
Human Resources |
Online |
| OTA Work Request Form |
Administration |
PDF |
| OTA Work Request Form |
Governing Board |
PDF |
| Patient Comment Form |
Quality |
PDF |
| Submit a Bid |
Administration |
Online |
| Telephone Screening Form |
Medical |
PDF |
| TJC National Patient Safety Goals 2023 |
Quality |
PDF |
