Patient Forms

General Forms

• File

  Advanced Directives (PDF)
• File

  Non Discrimination Notice (PDF)
• File

  Non Discrimination Notice (Spanish, PDF)
• File

  Speak Up (PDF)
• File

  Patient Bill of Rights (DOC)
• File

  Patient Bill of Rights (Spanish, PDF)
• File

  Out of Network Notice (DOC)
• File

  HIPAA Privacy (PDF)
• File

  EMSC Public Notice of Ownership (DOC)
• File

  Notice Regarding Patient Protections Against Surprise Billing (PDF)
• File

  Right to Receive a Good Faith Estimate of Expected Charges (PDF)
• File

  EMSC Public Notice of Ownership (PDF)