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BRIGHT STAR AMBULANCE INC Consent and Authorization Fax (331)4547725Dispatch (331)45477261559 US RT 34, Oswego IL 60543Parent Information: Name: Address: Date Of Birth: SSN: Contact Number: () Cell
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It is a form required by BrightStar EMS for consent and authorization purposes.
All individuals receiving medical services from BrightStar EMS are required to fill out this form.
The form can be filled out online or in person at BrightStar EMS facilities.
The purpose of the form is to obtain consent and authorization from individuals receiving medical services.
The form requires basic personal information, medical history, emergency contact information, and consent for treatment.
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