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Downloads and Forms

The following forms are available as PDF files for you to download, review, and print as necessary.

  • Notice of Privacy Practices — Maintaining the security of your personal health information is one of Mid-Valley Hospital's priorities. This document explains the privacy guidelines which apply to our facilities.
  • Charity Care Application — This form helps gather the data that Mid-Valley Hospital needs in order to process a request for charity care.
Contact Us:

Phone: (509) 826-1760
Fax:   (509) 826-7211
E-Mail: webmaster@mvhealth.org


Our Address:

Mid-Valley Hospital
810 Jasmine St
PO Box 793
Omak, WA 98841


Web Services: