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AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION Please complete each section highlighted in yellow and fax or mail to:10007Mail / Fax date BEFORE 06/30/2022: Fax to 4105829436. Mail to 1405 Madison
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Access the MIEMSS website.
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Click on the forms section.
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Emergency medical services providers in Maryland.
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Healthcare facilities in Maryland.
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Public health authorities in Maryland.
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MIEMSS stands for Maryland Institute for Emergency Medical Services Systems. It is the agency responsible for the coordination and regulation of the Maryland statewide emergency medical services (EMS) system.
All EMS agencies operating in the state of Maryland are required to file reports with MIEMSS.
EMS agencies can fill out the necessary reports online through the MIEMSS website or by submitting paper forms to the agency.
The purpose of MIEMSS is to ensure the delivery of quality emergency medical services to the residents of Maryland, as well as to regulate and monitor EMS providers in the state.
EMS agencies must report data on patient care, response times, equipment and personnel, as well as any incidents or complaints.
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