Bay Shore Brightwaters Rescue Ambulance, Inc
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PCR Request

PCR by Mail

To request a Patient Care Report (PCR) by mail, please follow the directions below:
  1. Completed Authorization For Release of Health Information Pursuant to HIPAA (OCA Official Form No.: 960). The form can be found here.
  2. Mail to:

Bay Shore Brightwaters Rescue Ambulance
Attention: Laurie Hughes-Records Request
911 Aletta Place
Bay Shore, NY 11706

PCR Online

To request a Patient Care Report (PCR) online, please follow the directions below:
  1. Completed Authorization For Release of Health Information Pursuant to HIPAA (OCA Official Form No.: 960). The form can be found here.
  2. Upload the form below
    Max file size: 20MB
Submit

BSBRA

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  • Home
  • Latest News
  • Volunteer
  • Donate
  • Community
    • CPR Training
    • Links
  • About Us
    • History
    • Apparatus
    • Current Chief/President
  • Members Area
  • Contact
    • PCR Request