PATIENT FINANCIAL SERVICES: SHEILA WHITING, COORDINATOR 937.840.6512
For assistance with financing medications, with the option of searching by diagnosis:
To complete a Medicaid application online:
Financial Assistance Application
This form must be printed and completed with physical signature at Highland District Hospital
OR
Print and complete the form with physical signature and send to:
Highland District Hospital
Attn: Patient Financial Services
1275 N. High Street
Hillsboro, Ohio 45133