- Durable Power of Attorney for Health Care Decisions (Medical Power of Attorney) (121)
- Declaration Relating to Life-Sustaining Procedures (Living Will) and Durable Power of Attorney for Health Care Decisions (Medical Power of Attorney) (123)
Your Rights and Responsibilities as a Patient
- Waverly Health Center's Patient Rights and Responsibilities
- Waverly Health Center's Patient Rights and Responsibilities (Spanish)
Patient Privacy (HIPAA)
- Waverly Health Center's HIPAA Privacy Notice
- Authorization to Disclose Protected Health Information – To have WHC send your records to another facility or provider.
- Request to Access Protected Health Information – To request copies of your medical record for your information or to hand deliver to another facility or provider.
As a recipient of Federal financial assistance, the health center does not exclude, deny benefits to, or otherwise discriminate against any person on the basis of race, color, national origin, disability, or age in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, whether carried out by the health center providers directly or through a contractor or any other entity with which the health center providers arrange to carry out its programs and activities.
Iowa Physician Orders for Scope of TreatmentIPOST Information
Tobacco Free Campus
We are a TOBACCO-FREE campus. The use of tobacco products is not allowed on our grounds and in our buildings.
Weapons Free Campus
We are a WEAPONS-FREE campus. Weapons are not allowed on our grounds and in our buildings.
Lost & Found
Our Lost & Found is located at the green entrance registration desk. Items are kept for 60 days.