Patient Resources & Forms

Hutch Regional wants to make every patient’s stay with us as easy and comfortable as possible.

The links below include important forms and information for our guests.

• Durable Power of Attorney for Health Care Decisions
• Declaration – Living Will
• Health Care Directive
• Do Not Resuscitate Order Request Form
• Kansas General Durable Power of Attorney
• Medical Alert Information
• Consent for Treatment of a Minor
• Authorization for Release of Information (Hutchinson Regional Medical Center)
• Authorization for Release of Information (Hutchinson Regional Physician Network)
• Authorization for Release of Information (Horizons)
• Your Rights and Protections Against Surprise Medical Bills

Try our new HutchCares payment option. Pay your bill in full and save.

Report a concern or complaint

Every patient has the right to report a concern or complaint, and Hutchinson Regional Medical Center has a formal system to handle both.

You can call 620-513-3866 for a hospital representative, or call our compliance hotline at 855-998-9907.

Please allow us the opportunity to resolve your concerns or complaints.

If you believe your concern or complaint has not been resolved to your satisfaction you may call the Kansas Department of Health and Environment at 1-800-842-0078.

To report a concern or complaint to the Joint Commission, send your information one of these ways:

• Email: patientsafetyreport@jointcommission.org
• Fax: 630-792-5636
• Mail: Office of Quality and Patient Safety
  The Joint Commission
  One Renaissance Boulevard
  Oakbrook Terrace, Illinois 60181