For all EMS Billing and Patient information questions please contact
Center Township Trustee
Judy White
115 S. Washington St. Danville, IN 46122
(317) 745-2813
Patient Information Forms
All forms are downloadable in Adobe PDF
Privacy Practices Complaint Procedure.pdf
Request for Amendment of PHI.pdf
Patient Request for Restriction.pdf
Patient Request for Access.pdf
Authorization to Use and Disclose Specific PHI.pdf