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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
To request digital records www.ChartSwap.com 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 Departments. 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.
Forms:
Request for Disclosure of Health Information
For Billing Disputes, Statements, Hardship:
Change Healthcare Office: 1.800.226.1012
Fax: 305.591.4660