Rescue Transport Report Request


Mail the subpoena or records request with HIPAA release to:
City of Hollywood Fire/Rescue, Attn: Medical Records Custodian,
2741 Stirling Road, Hollywood, FL., 33312-6505

OR to only request BILLING records and use HOLLYWOOD EMS.

Attorneys or patients sending a payment include the account number/patient name.
Mail to City of Hollywood Fire/Rescue, Attn: Billing,
2741 Stirling Road, Hollywood, FL., 33312-6505.

Hospitals, Medical Examiner, Police Depts. or other Govt. entities:
Contact Fire Rescue EMS Division 954.967.4248


Complete the appropriate form, mail to the address provided with a copy of the applicants photo ID, if applicable, a Power of Attorney and a copy of the Death Certificate.

Request for Disclosure of Health Information
Hardship Request

Billing Disputes, Statements, Hardship prior to DECEMBER 31,2021:
1.888.980.9234 / 1.888.317.2914

Billing Disputes, Statements,
Hardship after DECEMBER 31, 2021:
Change Healthcare Office: 1.800.226.1012
Fax: 305.591.4660