Facility Transport Information
(For Use by Healthcare Facilities Only)
To Schedule an Ambulance Transport
- Please download the Noga Ambulance PCS form below
- Complete this form in its entirety and fax forms to (724) 652-4848 before calling the dispatch center to schedule your transport
- Attach the hard copy of the completed PCS to the front of the patient’s paperwork for our crews to pick up upon transport
When Our Crews Arrive for Your Transport
- Please have paperwork ready along with a quick verbal patient care report
- This verbal report is required prior to any transfer of care to an EMS agency
- Report to include…reason patient requires an ambulance for transport, medical history, and any additional relevant information
- In the event, the patient is unable to sign. Our crew will ask you to sign our computerized Patient Encounter Form
- This form is required by federal law and does not violate HIPAA, nor does it make you financially liable for payment
Questions? Call our communication center (724) 652-6677
Downloads