Southern Dominion Health System, Inc. strives to serve our patients with quality healthcare. Below we have provided documents and information to make it simpler for you and help expedite your care upon arrival at one of our locations.

 

What to Bring:

Please print and complete the appropriate form(s). Bring the completed forms with you to your appointment.

 

You Will Also Need to Bring:

  • ID
  • Insurance Card (if applicable)
  • Sliding Fee Form (if applicable)
    • Get Form (PDF)
    • Get Form (Word Document)
    • SDHS, Inc. is a Federally Qualified Health Center(FQHC) which allows us to offer a Sliding Scale Discount to qualifying patients. The Sliding fee discount is based on household income and number of dependents in the household.

Notice of Privacy Practices:
Click HERE to view this notice describes how information about you may be used and disclosed and how you can get access to this information.

 

Patient Bill of Rights

The Board of Directors and Staff of Southern Dominion Health System, Inc. (SDHS) respect your rights as a patient and recognize that you are an individual with unique health care needs. We want you to know your rights as a patient as well as your obligations to yourself, other patients, your provider of care and this organization. Please click HERE to read your rights.

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