top of page

CANYON COUNTY DOCUMENTS

HIPAA Policy

This notice describes how medical information collected by Canyon County Paramedics may be used and disclosed, and how patient's can access this information. 

Patient Signature Form

Purpose:      Authorization to bill for services and that you                          have been informed about our HIPAA policy.

​

For use by:  Canyon County Patients or Patient's Authorized                        Representative

​

Fax to:          (208) 795-6960

Physician Certification Statement (PCS)

Purpose:      Medical necessity for ambulance transport

​

For use by:  Physicians

​

Fax to:          (208) 795-6960

Advance Beneficiary Notice of Non-Coverage (ABN)

Purpose:      To allow patients to make an informed decision                       about their transportation.

​

For use by:  Canyon County Patients

​

Fax to:          (208) 795-6960

bottom of page