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Welcome to the City of Papillion, NE, Mayor's Hotline
Today is Saturday, December 16, 2017.
EMS Billing Inquiries

Purpose. This form is used to communicate with Fire Department personnel to request information regarding your EMS billing for emergency ambulance transports.

* Information is required.

Contact Information

First Name:
Last Name:
Business Name:
Email:
Daytime Phone: (
Fax: (
Address:
City:
State:
ZIP:

What was the date of the emergency transport?
 
Please list the patients name and date of birth.
 
Nature of the complaint/suggestion...
 
Check here to have email confirmation of this submission.

* Information is required.

Notes:

If you send us a message, you will receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.

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