Please print and fill out this form prior to your appointment. You may also fax or mail it to the clinic.
The Patient Bill of Rights & Responsibilities defines your rights and responsibilities as a patient while you are contacting or visiting White Cloud Health Center. We want to make your visit as pleasant as possible by providing excellent customer service and quality care. In return, we expect that our staff is treated in the same manner.
You can download the Patient Bill of Rights & Responsibilities, below.