Beaufort Memorial Hospital | Affiliated with Duke University Health System in heart and cancer

Patient & Visitor Information

Free Forms

Advance Directives (Living Will & Healthcare Power of Attorney)
Make your wishes known about how you want things handled at the end of your life. You can complete the forms here, or go to the American Hospital Association web site on the subject at www.putitinwriting.org to get more forms and information.

Financial Assistance Application Form

For patients to print out from home for financial assistance.
>> Download the financial assistance application
>> Complete the online version of the Financial Assistance Form

Universal Medication Form (UMF)
Make sure healthcare providers are aware of the medications you are currently taking. Complete a Universal Medication Form (UMF), and keep it with you at all times. Update it as your medicines change. It could save your life.

Problems downloading forms?
If you are having trouble downloading a form you may need to turn popup blocker off in your internet browser preferences.

The forms and pages you can view from this site have been optimized to work with Internet Explorer, version 5.5 or later. The latest version of Internet Explorer is the recommended version for complete compatibility.

If you don't have the current version of Internet Explorer installed on your computer, click here to download it from Microsoft.

>> Back to top