Patient Information

Home > For Patients > Patient Information


patient information

Thank you for your interest in Siouxland Community Health Center.  We are proud to serve as your medical home and commit to a quality experience for your health care needs.

What to Bring On Your First Visit

For your first visit at Siouxland Community Health Center, you will be asked to complete new patient forms.  These forms become part of your medical chart and include demographic information such as your address, phone number, employment and insurance carriers.  Other new patient forms will include a basic questionnaire of your personal and family health history.  To qualify for our sliding fee programs, uninsured or privately insured patients are also asked to bring two forms of proof of their household income.  A financial counselor will assist with this process.

To make an appointment: Call us at 712-252-2477 or toll free at 888-371-1965

To request medical records: Fax 712-252-5920

To make a dental appointment: Call us at 712-226-9089 or toll free at 888-371-1965

Patient Bill of Rights and Responsibilities

Siouxland Community Health Center (SCHC) respects each patient and is dedicated to giving the best care possible. Patient Rights and Responsibilities explain what you can expect from us and, in turn, what we expect of you.

You have the right to:

  1. Private and confidential care
  2. Receive care despite sex, age, marital status, national origin, religion, creed, disability, or
    financial status.
  3. To be treated with respect, courtesy, and dignity.
  4. Ask questions about your healthcare and receive answers
  5. Obtain the information/education you need to make decisions about your healthcare.
  6. Change providers
  7. To receive information about advance directives
  8. Reasonable access to care
  9. Say no to treatment
  10. Be assessed for pain
  11. Get advice/instructions for emergent healthcare needs after the clinic is closed
  12. Know the names and qualifications of SCHC staff
  13. Apply for financial assistance (sliding fee scale)
  14. Interpreter services
  15. Correct inaccurate information
  16. Not participate in research projects
  17. Provide feedback or file a complaint about your treatment or care. Request to speak with a
    manager regarding your feedback or complaint.

You are Responsible for:

  1. Your health.
  2. Following instructions given by your healthcare provider.
  3. Providing accurate information about medications you are taking, your health issues, problems,
    and allergies
  4. Letting staff know if you do not understand information given to you
  5. Behaving with respect and courtesy towards other patients and the SCHC staff
  6. Telling your provider about your pain
  7. Calling about non-emergent health problems during office hours
  8. Getting your medication before running out
  9. Calling 24 hours in advance if unable to keep an appointment
  10. Getting annual check-ups
  11. Inform SCHC if you plan to move your health or dental care to a different clinic
  12. Informing SCHC of your current insurance plan
  13. Paying your co-pay at each visit and trying to pay your bills on time.