Patient Services

PATIENT FINANCIAL SERVICES: SHEILA WHITING  937-840-6512

For assistance with financing medications, with the option of searching by diagnosis:

Click Here

To complete a Medicaid application online:

Click Here

Financial Assistance Application

Download 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