Rescue Hose and Ladder Company Ambulance Service is required by law to maintain the privacy of certain confidential health care information, known as Protected Health Information, or PHI, and to provide you with a notice of our legal duties and privacies with respect to your PHI. Rescue Hose and Ladder Company Ambulance Service is also required to abide by the terms of the version of this Notice currently in effect.
Uses and Disclosures of PHI: Rescue Hose and Ladder Company Ambulance Service may use PHI for the purposes of treatment, payment, and health care operations, in most cases without your written permission. Examples of our use of your PHI are the following:
Reminders for Scheduled Transports and Information on Other Services: We may also contact you to provide you with a reminder of any schedules appointments for non-emergency ambulance and medical transportation, or to provider information about other services we provide.
Use and Disclosure of PHI Without Your Authorization: Rescue Hose and Ladder Company Ambulance Service is permitted to use PHI without your written authorization, or opportunity to object, in certain situations, and unless prohibited by a more stringent state law, including:
Any other use or disclosure of PHI, other than those listed above will only be made with your written authorization at any time, in writing, except to the extent that we have already used or disclosed medical information in reliance on that authorization.
Patient Rights: As a patient, you have a number of rights with respect to your PHI, including:
Privacy Officer Contact Information:
Rescue Hose and Ladder Company Ambulance Service
408-410 Filbert Street Curwensville PA 16833
Shift Supervisor Phone: (814) 603-1410
Station Phone: (814) 236- 2960
Billing Office Phone: (814) 236-3111.
Rescue Hose and Ladder Co. Ambulance Service
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION PLEASE REVIEW IT CAREFULLY.
For a Printable Copy of this form, and a copy of the signature form, click this link!
Rescue Hose & Ladder Company
These Privacy Practices are the practices and policy of the Rescue Hose and Ladder Company. Houtzdale-Ramey EMS and Karthus Ambulance Service each have privacy practices of their own. Please contact their privacy officer for a copy of their practices.