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
If you have any questions or concerns please feel free to contact The Executive Assistant to The Fire Chief and Fire Marshal Erin Gaudet.
Office Number - 203-453-8045
Fax Number - 203-453-8416