Admission & Discharge Forms

For instructions on completing and filing the forms below, please contact the Laguna Honda Admission Office at (415) 682-5683 or fax (415) 682-5689.

Admission Application & House Rules

REAL Posters

REAL Poster English | REAL Poster Chinese | REAL Poster Russian | REAL Poster Spanish |REAL Poster Tagalog | REAL Poster Vietnamese

Summary Notice of HIPAA Privacy Practices and Acknowledgement of Receipt

Chinese | English | Russian | Spanish | Tagalog | Vietnamese

Full Notice of HIPAA Privacy Rights

Chinese | English | Russian | Spanish | Tagalog | Vietnamese

Consent for Treatment

Chinese | English | Russian | Spanish | Tagalog | Vietnamese

Price Transparency: View Laguna Honda Hospital Pricing

Help Paying Your Bill

Last updated December 18, 2024

Related

Services Provided at Laguna Honda Hospital
Help Paying Your Bill – Laguna Honda Hospital

For support on how to apply for our Charity Care and Discount Payment financial assistance programs, which can help you pay your bill.

Laguna Honda Hospital Admission, Discharge, and Price Transparency
Laguna Honda Campus Tours

We are excited to offer in-person tours and invite you to see our beautiful facility and campus!

Departments

Laguna Honda Hospital and Rehabilitation Center
Department of Public Health