Ambulance Forms


Insurance requires a medical necessity form or a PCS, (also known as a physician certification statement) to be filled out for each ambulance transport, that lists the justification for the transport by ambulance. This form must be filled out prior to the transport and be signed by an eligible medical professional. Do you need a medical necessity form? Feel free to download the form below.

For each transport request our dispatchers will ask a series of questions to make sure we have all needed information about the patient, prior to transport. You may download this form for reference or fill it out in advance and send it in with your transport request.