SERVICES TRAINING JOIN OUR TEAM NEWS PATIENT RESOURCES ABOUT US CONTACT PATIENT RESOURCES Documents & Forms Notice of Privacy Practices Make a Payment DOCUMENTS & FORMS PATIENT RELATED FORMS Patient Request for Access Form Patient Request for Restriction Form Authorization to Use and Disclose Pt Records Patient Notice of Privacy Practice Ambulance Med Nec Signature Form Patient Billing Authorization Signature Form We are the Western Massachusetts leaders in providing ambulance and chair car service. About Us Facebook Twitter Instagram CONTACT US (413) 499-2527 bkandrews@countyamb.com 175 Wahconah Steet Pittsfield, MA 01201 © 2021 County Ambulance All rights reserved. TEAM RESOURCES EMS Manager/Scheduling Website Remote Email Portal ESO Solutions ePCR Website Ninth Brain Forms Submissions McNeil Training Portal

SERVICES TRAINING JOIN OUR TEAM NEWS PATIENT RESOURCES ABOUT US CONTACT CONTACT Contact Us Recognize an Outstanding Team RECOGNIZE AN OUTSTANDING TEAM WE LOVE TO RECOGNIZE OUR TEAM MEMBER’S PERFORMANCE. Our team is noted for providing exceptional clinical care and outstanding customer service. When we know about it we make sure they get recognized for their outstanding efforts. If you have one of these experiences you would like to share with us so we can acknowledge our team members please complete this form. We respect your privacy and will not publicly share your information. We are the Western Massachusetts leaders in providing ambulance and chair car service. About Us Facebook Twitter Instagram CONTACT US (413) 499-2527 bkandrews@countyamb.com 175 Wahconah Steet Pittsfield, MA 01201 © 2021 County Ambulance All rights reserved. TEAM RESOURCES EMS Manager/Scheduling Website Remote Email Portal ESO Solutions ePCR Website Ninth Brain Forms Submissions McNeil Training Portal

SERVICES TRAINING JOIN OUR TEAM NEWS PATIENT RESOURCES ABOUT US CONTACT CONTACT Contact Us Recognize an Outstanding Team CONTACT US County Ambulance Service Our Address 175 Wahconah Street Pittsfield, MA 01201 Dispatch Operations: (413)499-2527 Dispatch Fax: (413)442-1535 Billing Office: (413)443-4335 Billing Fax: (413)443-5472 GOOGLE MAP We are the Western Massachusetts leaders in providing ambulance and chair car service. About Us Facebook Twitter Instagram CONTACT US (413) 499-2527 bkandrews@countyamb.com 175 Wahconah Steet Pittsfield, MA 01201 © 2021 County Ambulance All rights reserved. TEAM RESOURCES EMS Manager/Scheduling Website Remote Email Portal ESO Solutions ePCR Website Ninth Brain Forms Submissions McNeil Training Portal