Medical Records Request

Wayne Township Memorial First Aid Squad is committed to protecting our patients personal health information. We are required by law to maintain the privacy of health information that could reasonably be used to identify you, known as “protected health information” or “PHI.” All requests for records must have patient's or next of kin HIPAA release form. No medical record(s) will be sent unless fee is paid and HIPAA forms are correctly submitted.

To obtain our medical records/call slip please send the appropriate HIPPA forms along with a $55 check made out to Wayne First Aid Squad.

All money from the medical request records goes directly to provide supplies and equipment, maintain our vehicles, and meet our everyday needs.