To request billing information and/or request records, please send us the following information on a Patient Authorization (to release records) Form that is signed and dated by the patient. The form should include the following information:
● Patient Name
● Patient Date of Birth
● Name/Town of the Ambulance Service
● Date of Service
Submit your request via e-mail to firstname.lastname@example.org.
We will return the requested information to you via a secure e-mail.
We will respond to your request within 7-10 business days.
To inquire about the status of your request please e-mail email@example.com
Affiliates of VSS Medical Technologies
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