NH+C Forms

Forms and Documents

NH+C Forms

Name
Field 2023 Audit Value
Filemime

Name

Name

Authored

Changed

2023 Audit

File MIME type

Your Rights and Protections Against Surprise Medical Bills

Your Rights and Protections Against Surprise Medical Bills application/pdf

Winter 2023

Winter 2023 application/pdf

When A Loved One Dies Booklet

When A Loved One Dies Booklet Keep application/pdf

What over-the-counter medications are safe for me to take

What over-the-counter medications are safe for me to take Keep application/pdf

Tdap Vaccine Information Sheet.pdf

Tdap Vaccine Information Sheet.pdf Keep application/pdf

Spring 2023

Spring 2023 application/pdf

Sleep Study Order Form.pdf

Sleep Study Order Form.pdf Keep application/pdf

Short form HCD fillable.pdf

Short form HCD fillable.pdf Keep application/pdf

september_2024_bod_minutes_acc.pdf

september_2024_bod_minutes_acc.pdf application/pdf

September 2023 BOD Minutes

September 2023 BOD Minutes application/pdf

September 2022 BOD Minutes

September 2022 BOD Minutes application/pdf

Right to Receive a Good Faith Estimate of Expected Charges Notice

Right to Receive a Good Faith Estimate of Expected Charges Notice application/pdf

ReShape U 2024 Flyer

ReShape U 2024 Flyer application/pdf

Reference Lab Requisition

Reference Lab Requisition application/pdf

Post Offer Physical Screen EMS

Post Offer Physical Screen EMS application/pdf

PEARS Registration Letter.pdf

PEARS Registration Letter.pdf application/pdf

PDS Home Sleep Test Instructions

PDS Home Sleep Test Instructions application/pdf

Patient Grievance Form Fillable_0.pdf

Patient Grievance Form Fillable_0.pdf Keep application/pdf

Patient Grievance Form - Spanish fillable_0.pdf

Patient Grievance Form - Spanish fillable_0.pdf Keep application/pdf

october_2024_bod_minutes_acc.pdf

october_2024_bod_minutes_acc.pdf application/pdf

October 2023 BOD Minutes

October 2023 BOD Minutes application/pdf

October 2022 BOD Minutes

October 2022 BOD Minutes application/pdf

november_2024_bod_minutes_acc.pdf

november_2024_bod_minutes_acc.pdf application/pdf

November 2023 BOD Minutes

November 2023 BOD Minutes application/pdf

November 2022 BOD Minutes

November 2022 BOD Minutes application/pdf

nhc_annual_report_2024.pdf

nhc_annual_report_2024.pdf application/pdf

nhc_annual_report_2023.pdf

nhc_annual_report_2023.pdf application/pdf

NHC BLS Student Information Packet.docx_0.pdf

NHC BLS Student Information Packet.docx_0.pdf application/pdf

NHC BLS and ACLS Student Information Packet_0.pdf

NHC BLS and ACLS Student Information Packet_0.pdf application/pdf

NH+C Annual Report 2022.pdf

NH+C Annual Report 2022.pdf application/pdf

NH+C Annual Report 2021.pdf

NH+C Annual Report 2021.pdf application/pdf

NF Mailing Packet

NF Mailing Packet application/pdf

MyHealthAdult Proxy Form

MyHealthAdult Proxy Form Keep application/pdf

MyHealth Sign-up Form

MyHealth Sign-up Form Keep application/pdf

MyHealth Child Proxy Form

MyHealth Child Proxy Form Keep application/pdf

Medication Disposal Spanish

Medication Disposal Spanish application/pdf

may_2025_bod_minutes_acc.pdf

may_2025_bod_minutes_acc.pdf application/pdf

may_2024_bod_minutes_acc.pdf

may_2024_bod_minutes_acc.pdf application/pdf

May 2023 BOD Minutes

May 2023 BOD Minutes application/pdf

May 2022 BOD Minutes

May 2022 BOD Minutes application/pdf

march_2025_bod_minutes_acc.pdf

march_2025_bod_minutes_acc.pdf application/pdf

March_2024_BOD_Minutes.pdf

March_2024_BOD_Minutes.pdf application/pdf

March 2023 BOD Minutes

March 2023 BOD Minutes application/pdf

March 2022 BOD Minutes

March 2022 BOD Minutes application/pdf

june_2024_bod_minutes_acc.pdf

june_2024_bod_minutes_acc.pdf application/pdf

June 2023 BOD Minutes

June 2023 BOD Minutes application/pdf

June 2022 BOD Minutes

June 2022 BOD Minutes application/pdf

july_2024_bod_minutes_acc.pdf

july_2024_bod_minutes_acc.pdf application/pdf

July 2023 BOD Minutes

July 2023 BOD Minutes application/pdf

July 2022 BOD Minutes

July 2022 BOD Minutes application/pdf

january_2025_bod_minutes_acc.pdf

january_2025_bod_minutes_acc.pdf application/pdf

January 2024 BOD Minutes

January 2024 BOD Minutes application/pdf

January 2023 BOD Minutes

January 2023 BOD Minutes application/pdf

January 2022 BOD Minutes

January 2022 BOD Minutes application/pdf

Include Always Application

Include Always Application Keep application/pdf

Honoring Choices MN HCD_0.pdf

Honoring Choices MN HCD_0.pdf Keep application/pdf

Grief Support Brochure 2023-2024

Grief Support Brochure 2023-2024 application/pdf

financial-assistance-application.pdf

financial-assistance-application.pdf Keep application/pdf

FINAL-POLST-for-patients-and-families-nov-2017.pdf

FINAL-POLST-for-patients-and-families-nov-2017.pdf application/pdf

february_2025_bod_minutes_acc.pdf

february_2025_bod_minutes_acc.pdf application/pdf

February_2024_BOD_Minutes.pdf

February_2024_BOD_Minutes.pdf application/pdf

February 2023 BOD Minutes

February 2023 BOD Minutes application/pdf

February 2022 BOD Minutes

February 2022 BOD Minutes application/pdf

Disclosure Notice Regarding Patient Protections Against Surprise Billing spanish

Disclosure Notice Regarding Patient Protections Against Surprise Billing spanish application/pdf

december_2024_bod_minutes_acc.pdf

december_2024_bod_minutes_acc.pdf application/pdf

December_2023_BOD_Minutes.pdf

December_2023_BOD_Minutes.pdf application/pdf

December 2022 BOD Minutes

December 2022 BOD Minutes application/pdf

CPAP Medicare HCPCS Replacement Schedule

CPAP Medicare HCPCS Replacement Schedule application/pdf

Community Resources List

Community Resources List application/pdf

CLIA Certificate 2023 to 2025

CLIA Certificate 2023 to 2025 application/pdf

Chargemaster_8/24

Chargemaster_8/24 text/csv

bod_august_2024_minutes_acc.pdf

bod_august_2024_minutes_acc.pdf application/pdf

Auxiliary scholarship award app.pdf

Auxiliary scholarship award app.pdf application/pdf

Auxiliary Brochure

Auxiliary Brochure application/pdf

Authorization ROI Form

Authorization ROI Form Keep application/pdf

Authorization for Disclosure Form

Authorization for Disclosure Form Keep application/pdf

august_2024_bod_minutes_acc.pdf

august_2024_bod_minutes_acc.pdf application/pdf

August 2023 BOD Minutes

August 2023 BOD Minutes application/pdf

August 2022 BOD Minutes

August 2022 BOD Minutes application/pdf

april_2025_bod_minutes_acc.pdf

april_2025_bod_minutes_acc.pdf application/pdf

april_2024_bod_minutes_acc.pdf

april_2024_bod_minutes_acc.pdf application/pdf

April 2023 BOD Minutes

April 2023 BOD Minutes application/pdf

April 2022 BOD Minutes

April 2022 BOD Minutes application/pdf

416007241_Northfield-Hospital_standardcharges.csv

416007241_Northfield-Hospital_standardcharges.csv text/csv

2025 NH+C Magazine - Winter

2025 NH+C Magazine - Winter Keep application/pdf

2025 NH+C Magazine - Spring (PDF)

2025 NH+C Magazine - Spring (PDF) Keep application/pdf

2025 Clinic Publication.pdf

2025 Clinic Publication.pdf application/pdf

2024 NH+C Magazine - Winter

2024 NH+C Magazine - Winter Keep application/pdf

2024 NH+C Magazine - Spring

2024 NH+C Magazine - Spring application/pdf

2024 NH+C Magazine - Fall

2024 NH+C Magazine - Fall Keep application/pdf

2024 Chargemaster

2024 Chargemaster text/csv

2024 Average Charge per DRG Upload.xlsx

2024 Average Charge per DRG Upload.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet

2023 Northfield Hospital standard charges

2023 Northfield Hospital standard charges text/csv

2023 NH+C Magazines- Spring (PDF)

2023 NH+C Magazines- Spring (PDF) application/pdf

2023 NH+C Magazine- Winter (PDF)

2023 NH+C Magazine- Winter (PDF) application/pdf

2023 NH+C Magazine - Fall

2023 NH+C Magazine - Fall Keep application/pdf

2022 NH+C Magazine - Winter

2022 NH+C Magazine - Winter application/pdf

2022 NH+C Magazine - Spring

2022 NH+C Magazine - Spring application/pdf

2022 NH+C Magazine - Fall

2022 NH+C Magazine - Fall application/pdf