Patient Access to PHI Request


 Fire & EMS Home > Resources & Services > Patient Access to PHI Request

 

As a patient, you have the right to access, copy or inspect your Protected Health Information (or PHI) in accordance with federal law. To access your PHI, please complete the form below.

 

Patient Request to Access PHI

 

Fire truck with ladder sitting outside Station #1

 MISHAWAKA
FIRE & EMS

8:30am-4:45pm
Mon-Fri

3000 E. Harrison Road
Mishawaka, IN  46544

Phone:  (574) 257-0620
Fax:  (574) 258-1698

 

Fire Chief

Bryon Woodward