San Juan County Hospital District No. 1
San Juan EMS
Village at the Harbor
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San Juan County Public Hospital District No. 1
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San Juan County Public Hospital District No. 1

District Forms

Employee Finance Forms

Employee Travel Reimbursement Form
Employee Miscellaneous Reimbursement Form
Employee Credit Card Log Form

Employee Benefits Forms

W-9 Form
DRS Address or Name Change Form
DRS Beneficiary Change Request
PMFL Required Notice to Employees Form
FMLA Eligibility Notice Form
FMLA Designation Notice Form

Public Records Request Forms

Public Records Request Form
Employee Public Records Search Form

San Juan County Hospital District No. 1

535 Market Street, Suite E
Friday Harbor, WA 98250
(360) 378-2857
Hours: Monday to Thursday
9:00am - 5:00pm

San Juan Island EMS

P.O. Box 2178 ~ 1079 Spring Street
Friday Harbor, WA 98250
Business Offices: (360) 378-5152
Billing: (800) 238-9398
Fax: (360) 378-3583

Village at the Harbor

543 Spring Street
Friday Harbor, WA 98250
Office: (360) 378-7144
Fax: (360) 472-4011

San Juan County Public
Hospital District No. 1

P.O. Box 370 ~ 535 Market Street, Suite E
Friday Harbor, WA 98250
Administrative Office: (360) 378-2857
Fax: (360) 378-2856

SAN  JUAN COUNTY PUBLIC HOSPITAL DISTRICT NO. 1 © COPYRIGHT 2025

  • Home
  • Meetings
    • PeaceHealth Docs
    • About SJCPHD#1 Meetings
    • 2024 Meeting Docs
    • 2023 Meeting Docs
    • 2022 Meeting Docs
    • 2021 Meeting Docs
    • 2020 Meeting Docs
    • 2019 Meeting Docs
    • 2018 Meeting Docs
    • 2014 – 2017 Meeting Docs
  • About the District
    • About the Hospital District
    • Policies and Procedures
    • District Forms
    • Inquiry for a Medicaid Apartment at Village at the Harbor
    • Housing For Healthcare Workers Project
  • Careers
  • Services
    • San Juan Island EMS
    • Village at the Harbor
    • Subsidies and Partnerships
    • Reproductive Services
  • News
  • Contact
    • Contact Our Office
    • District Commissioners
    • Public Records Requests
    • Media and Press
    • Maintenance Request