Compassion Health Toledo
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Hello, and welcome to Compassion Health Toledo! We are glad you are here. At CHT we are dedicated to providing quality care to everyone. In order to streamline your initial visit, we have provided electronic copies of forms for you to complete before you arrive. Please review the following forms and complete those that are applicable to you.
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Sliding Fee Application for Uninsured Patients
As a part of our commitment to providing access to high quality care to everyone regardless of income, we have implimented a sliding fee to ease the financial burden on our patients. This application is best suited for patients who are uninsured, or who have a high deductible and fall within our Sliding Fee Schedule. Applicants will be required to submit proof of identity and income at the time of the application. For more information about income eligibility, please see "2022 CHT Sliding Fee Schedule"
2022 CHT Sliding Fee Schedule
File Size: 103 kb
File Type: pdf
Download File

Initial Prenatal Forms
Coming Soon!​
Complaint/Grievance form
File Size: 18 kb
File Type: docx
Download File

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  • Home
  • Our Prenatal Program
  • Who We Are
    • About CHT
    • Mission, Vision, & History
    • Meet Our Staff
    • Board of Directors
  • Location
  • Support CHT
  • FAQs
  • Contact Us
  • Patient Info
  • En Español
  • Financials and annual reports
  • Career Opportunities
  • Patient Forms