FORMS & FAQs

FREQUENTLY ASKED QUESTIONS:

Q: What are your Hospital's Visiting Hours?

A: We do not restrict visiting hours in our main hospital or nursing Home.  Guests are welcome during times and under conditions established by the patient or resident themselves.  If an individual is being treated as an inpatient for Addiction Recovery or Mental Health, certain restriction to visits apply.  Please call 315.462.1050 to learn more.

 

Q:  How can I find out if a particular doctor's office is accepting new patients?

A:  Each practice makes this decision independently.  View our list of doctors and phone the practice in question directly.  

 

Q:  I was born at Clifton Springs Hospital.  How do I get a copy of my Birth Certificate?

A:  Contact the Village Clerk for the Village of Clifton Springs at 315.462.5151

 

Q:  How can I request a copy of my medical records?

A:  Use the Downloadable Forms to the right that best describes the records you require.  You can select records from The Hospital, Health First Family Medicine and/or Canal Park Family Medicine.  If the records you seek relate to services from independent physicians, contact their office directly.  You can view a list of practitioners and their contact information here.

 

Q:  How do I get assistance paying my bill?

A:  There are several forms of assistance for people who are either uninsured or for whom copayments with insurance create financial hardship.  When you register for your next appointment, ask a registration representative what options exist - or call our Patient Finance office. 

     If your last name starts with A-K, call 315.462.0452;    L-Z, call 315.462.0451.

     If you receive a bill in the mail and you can't afford to pay it, do not ignore it! 

 

Q: I have been asked to apply for Financial Aid.  What forms should I complete?

A: To apply for any financial assistance, you should complete a Financial Aid Application.  After your application is processed you may be asked to complete and submit a Repayment Agreement.

 

Q:  I submitted an application for employment.  What happens next?

A:  All applicants receive a postcard confirming receipt of their materials.  The Human Resources team works to identify the most qualified applicants for current openings based on education, experience and skills outlined in each applicant's application.  Not all applicants are contacted directly nor are interviews guaranteed.  

 

 

Don't see your question here?

You can submit your question using the Ask a Question link below.  We may use your question, and its answer, to assist others in the future.

Clifton Springs Hospital & Clinic Receives Three Year Quality Based Accreditation and Recommendation for ISO 9001 Certification. 

To read more click on DNV Announcement

Downloadable Forms

You will find various forms linked to pages throughout the site.  This is a collection of the ones most frequently requested:

Employment Application

Nursing Home Admission application

Medical Record Release forms:

-  for patients of Clifton Springs Hospital (including Seneca Falls and Newark Lab Stations and Canandaigua Behavioral Health and Addiction Recovery)

- for patients of Health First Family Medicine and Dr. Asfar Ahmed

- for patients of Canal Park Family Medicine and Dr. Laroche

CS Hospital 2 Coulter Road Clifton Springs, NY 14432 | Work Phone: 315-462-9561

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