Form IOCI15-31 Emergency Medical Services (EMS) Authorization for Release of Information - Illinois

Form IOCI15-31 Emergency Medical Services (EMS) Authorization for Release of Information - Illinois

What Is Form IOCI15-31?

This is a legal form that was released by the Illinois Department of Public Health - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is IOCI15-31?
A: IOCI15-31 is the form number for the Emergency Medical Services (EMS) Authorization for Release of Information in Illinois.

Q: What is the purpose of the IOCI15-31 form?
A: The purpose of the IOCI15-31 form is to authorize the release of medical information related to emergency medical services in the state of Illinois.

Q: Who can use the IOCI15-31 form?
A: The IOCI15-31 form can be used by individuals who have received emergency medical services in Illinois and need to authorize the release of their medical information.

Q: What information is included in the IOCI15-31 form?
A: The IOCI15-31 form includes details such as the individual's name, date of birth, contact information, the purpose of the release, and the specific information to be released.

Q: Is there a fee associated with submitting the IOCI15-31 form?
A: There is usually no fee associated with submitting the IOCI15-31 form, but it is recommended to check with the specific healthcare facility or provider for any possible charges.

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Form Details:

  • The latest edition provided by the Illinois Department of Public Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form IOCI15-31 by clicking the link below or browse more documents and templates provided by the Illinois Department of Public Health.

Download Form IOCI15-31 Emergency Medical Services (EMS) Authorization for Release of Information - Illinois

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  • Form IOCI15-31 Emergency Medical Services (EMS) Authorization for Release of Information - Illinois, Page 1
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