Phila form 82 311b 2025

Show details

4.4 out of 5

53 votes

The document is an authorization form for the release of confidential Pennsylvania Emergency Medical Services Reports, detailing the patient's medical history and treatment information. It outlines the necessary information required for the release, including patient details, purpose of disclosure, and conditions regarding HIV-related information. The form emphasizes patient rights regarding revocation of authorization and specifies that records cannot be released without the patient's signature or that of a legally qualified representative.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to quickly redact Phila form 82 311b online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Dochub is the greatest editor for changing your forms online. Follow this simple guide to edit Phila form 82 311b in PDF format online free of charge:

Register and sign in. Register for a free account, set a secure password, and go through email verification to start managing your templates.
Upload a document. Click on New Document and select the form importing option: upload Phila form 82 311b from your device, the cloud, or a secure link.
Make adjustments to the sample. Use the upper and left-side panel tools to redact Phila form 82 311b. Add and customize text, pictures, and fillable areas, whiteout unneeded details, highlight the important ones, and comment on your updates.
Get your documentation completed. Send the form to other parties via email, generate a link for faster document sharing, export the sample to the cloud, or save it on your device in the current version or with Audit Trail included.

Discover all the benefits of our editor today!

See more phila form 82 311b versions

We've got more versions of the phila form 82 311b form. Select the right phila form 82 311b version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (136 Votes)
2006	4.4 Satisfied (53 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I get a copy of a fire report in Philadelphia?

We encourage everyone who has internet access to apply for these reports through the Public safety reports portal. Please know that if you do not have internet access, you can still always use the paper application process.

How to obtain a Philadelphia police report?

In order to get a copy of your police report, you will have to submit a formal request to City Hall. Specifically, all accident report requests are processed through the Department of Records. You can choose to either submit your request via mail, utilize the online crash portal, or to go to the department in person.

How do I apply for EMS report in Philadelphia?

AUTHORIZATION FORM IS AVAILABLE AT: .PHILA.GOV/RECORDS GO TO POLICE/FIRE RECORDS UNIT CLICK EMERGENCY MEDICAL SERVICES (EMS) (form 82-311 C Int. ) TO EXPEDITE SERVICE, PLEASE SEND 2 SELF-ADDRESSED, STAMPED ENVELOPES. MAKE BUSINESS CHECKS OR MONEY ORDER PAYABLE TO CITY OF PHILADELPHIA.

How to report a car accident in Philadelphia?

Call 911. Even if the accident is clearly minor, you should leave it up to the dispatcher to determine whether the accident requires immediate police response. The dispatcher will assess whether to send a police officer by asking you a series of questions over the phone.

What is an EMS report?

For most emergency medical services (EMS), a prehospital care report (PCR) form records demographic data (name, address, billing information), vital signs (Glasgow Coma Scale, blood pressure, pulse and respiration rates, pain), a patient assessment, and details of any interventions that the EMS provider performed.