If you are a court-appointed guardian, custodian or representative of a minor, print this Patient Care Request form (PDF) and carefully follow the instructions on the form, including the instructions for returning it by mail.
The Fire Department will make every effort to respond to your request as quickly as possible. In most cases, you will receive a response within 10 working days.
If you are not a court-appointed guardian, custodian or representative of a minor patient, please select the description that applies to you.
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Revised April 8, 2004
Courthouse 