Forms
To help you prepare for your visit and streamline your care process, Schoolcraft Memorial Hospital provides online access to forms that may be necessary for your treatment. Having these documents available allows you to review and complete important paperwork at your convenience, ensuring you feel prepared and informed.
We encourage you to download and complete any relevant forms before your appointment.
Consent for Medical Treatment of a Minor
This form authorizes healthcare providers at Schoolcraft Memorial Hospital to provide medical treatment to a minor child in the absence of a parent or legal guardian. It is essential to ensure that your child can receive timely care even when you are not present.
Download Consent for Medical Treatment of a Minor Child Without Parent/Legal Guardian Present
Durable Power of Attorney
A Durable Power of Attorney for Health Care is a legal document that allows you to name a trusted individual, known as a patient advocate, to make medical decisions on your behalf if you become unable to do so. This form helps ensure your healthcare wishes are respected.
Download Durable Power of Attorney DPOA (Updated June 2021)
Release of Information for the Rural Health Clinic
This form grants permission for the Schoolcraft Memorial Hospital Rural Health Clinic to release your protected health information to a person or organization you designate. It is required to share your medical records for purposes such as coordinating care with other providers or for legal and insurance needs.
Download Medical Record Release of Information - Referral Other Facility to SMH - REV 12.2025
Medical Record Release of Information - Referral from SMH to Other - REV 12.2025
For Providers
We value our referring physician partners. For a smooth transition and clear communication, please use the referral form below.
Specialty Clinic Referral Form
Financial Assistance
We believe that all members of our community deserve access to high-quality care, regardless of their ability to pay. Our financial assistance program is available to patients who need help managing their medical expenses.
