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Privacy Practices & Policies

At Citizens Ambulance we care about your private information and do our part to secure it and keep it hidden from unauthorized personnel. Below you can find our Notice of Privacy Practices which will give you the most up-to-date information regarding how we handle your Protected Health Information (PHI).Below you can also find the Staff Notice of how we handle your PHI internally.
 
As part of being committed to protecting your PHI we CAN NOT release your PHI to anyone (even yourself) without proper documentation and identification.
 
In order to give you (or anyone else) copies of your PHI we will need the following from the person whose PHI we are releasing:
  • One Form of ID (Types Accepted are: Drivers License or ID, SS Card, Birth Certificate)
  • Signed and Dated & Most Recent Copy of Our PHI / HIPAA Release Form​
In the event of the death of the person whose PHI needs to be released we will need the following:
  • Death Certificate (Must be a Certified Copy)
  • One Form of ID from the Patient's Power of Attorney (Types Accepted are: Drivers License or ID, SS Card, Birth Certificate)
  • Signed and Dated & Most Recent Copy of Our PHI / HIPAA Release Form (This form will need to be signed by the Patients Power of Attorney
Privacy Questions or Concerns?

Contact Our Privacy Officer at 440-839-2144 Opt 6 or email Privacy@citizensambulance.com

Contact Us with Our Form: