Patient Forms
All patient forms currently used by MedCare Ambulance are listed below. Download the form(s) needed at your convenience and provide them to the MedCare Partners handling your transport upon their arrival.
If you have any questions about which forms may be required, contact MedComm at (877) 819-8193 for assistance
Are you looking for the MedCare Customer Satisfaction Survey? We would love to hear back from our patients, their families and our facilities. Take the survey here.
Are you looking for the MedCare Customer Satisfaction Survey? We would love to hear back from our patients, their families and our facilities. Take the survey here.
| Name | Updated | |
|---|---|---|
| Advance Beneficiary Notice | 2/3/2025 | Download |
| Ambulance Physician Certification | 12/7/2023 | Download |
| Ambulette Physician Certification | 12/7/2023 | Download |
| Consent for Release of Medical Records | 12/7/2023 | Download |
| Patient Transport Coversheet | 12/7/2023 | Download |
| otice of Privacy Practices Regarding Protected Health Information | 6/4/2026 | Download |