How do I request a copy of my medical report?

Attorneys 

ELECTRONIC www.ChartSwap.com and use HOLLYWOOD EMS


Patients Records Request

Mail to the address provided on the form with a copy of the patient’s & applicant’s government issued photo ID and if applicable a Power of Attorney and a copy of the Death Certificate.

Forms

Request for Disclosure of Health Information

Hardship Request

Billing Disputes, Statements, Hardship 

Change Healthcare Office: 1-800-226-1012 Fax: 305-591-4660

 

Payments for EMS Transport, Mail to Billing Lockbox

City of Hollywood & Beach Safety Department

P. O. Box 947121

Atlanta, GA 30394

 

Hospitals, Medical Examiner, Police Departments or other Gov’t. Entities

Contact Fire Rescue EMS Division 954-967-4248


Show All Answers

1. How do I obtain a copy of a Fire Incident or Fire Inspection Report?
2. How do I request a copy of my medical report?
3. How do I become a Florida certified Firefighter?
4. How do I become a Florida certified EMT/Paramedic?
5. Does the Hollywood Fire Department teach CPR?
6. Who do I contact to report a fire code violation at a business or other occupancy?
7. Who do I contact for a problem with a fire hydrant?
8. Does Hollywood Fire Department participate in telephone solicitation?