Request Patient Report Forms
A Patient Report Form (PRF) may be requested from ER24 by a patient, legal representative / power of attorney or legal guardian.
Patient Report Forms are considered to be medico-legal documentation. Medico-legal documentation may only be released with explicit written consent from the patient, legal representative / power of attorney or legal guardian, or upon order of a court and legal investigations.
Please ensure all of the required information is completed in the form below. Incorrect and incomplete information may result in a delay to release documentation.