Guilford Fire Department Ambulance Information
Patient Forms For Downloading
Patient Request For Access to Protected Health Information.
A clear copy of the patient’s and /or signee’s driver’s license MUST accompany this request. If a Financial or Medical POA, a copy of the POA form must also be included. If an Executor, provide a fiduciary certificate with the release, confirming appointment as executor.
Notice of Privacy Practices HIPAA Document