To comply with patient confidentiality and HIPAA guidelines, Wagoner Community Hospital requires a signed consent form before a patient can be interviewed and/or photographed at the hospital or a physician can be interviewed.

Below are links to copies of the consent forms for Wagoner Community Hospital. Please download the appropriate form(s) as needed and return to Business Development/Marketing. Thank you.

Wagoner Community Hospital

Business Development

1200 West Cherokee Street

Wagoner, OK 74467

Fax: (918) 485-9701

Download the Media Release Form:
Click here to download.

Download the Patient Consent / Authorization Form:
Click here to download.