Campbell County Memorial Hospital
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Patient Forms

Below is a list of the most common forms are used at Campbell County Health. Please complete and print them, then bring with you for your visit.

If you have any questions call 307.688.1301 or fax 307.688.1390. Please note that CCMH maintains records for 10 years from date of service for adults. CCMH maintains records until the child reaches age of majority plus 10 years.

CCMH Department Forms

Campbell County Medical Group Forms

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Who's caring for you?

Please refer to this uniform colors chart to help you understand who is caring for you.

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Website Survey

In 2016, Campbell County Health (CCH) is redesigning its website,, to help the organization provide the best quality care to our patients and residents. To begin this effort, we are asking the public to answer a six-question survey on what items they would like to have on our website. The survey should take no more than five minutes to complete and will closed at noon on Friday, January 29.