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Langley Health Services Langley Health Services
  • Home
  • About Us
    • About LHS
    • Executive Team
    • Langley Gives Back
  • Services
    • Family Practice
    • Pediatrics
    • Behavioral Health
    • Podiatry
    • Dental Services
    • Diagnostic Imaging
    • Laboratory
    • Pharmacy
    • COVID Information Center
  • Locations
    • Sumterville
    • Ocala
    • Inverness Medical
    • Inverness Dental
    • Lecanto
    • Crystal River
    • Homosassa
    • Mobile Dental Unit
    • Mobile Medical Unit
  • Patient Information Center
    • Healow App Information
    • Patient Forms
    • Sliding Scale Forms
    • Patients Rights
    • Resources/Upcoming Classes and Events
    • FAQ

Sliding Scale

and

Good Faith Estimate Forms

 

English

Sliding Scale application

 

Spanish

 Sliding Scale application- SPANISH

Creole

Sliding Scale application

 

GOOD FAITH ESTIMATE FORMS

English

Good Faith Estimate 

 

Spanish

Good Faith Estimate-Spanish

 

Langley Health Services Langley Health Services

Langley Health Services

1425 South US 301, Sumterville, FL 33585
phone: (888) 298-5510

© 2023 Langley Health Services

Accessibility Statement

Accredited by the Accreditation Association for Ambulatory Health Care, Inc.
Proud Partner of United Way of Lake & Sumter Counties
HRSA COVID-19 Data Reporter 2021 Awardee
PCMH


FTCA