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Health First Hospital Discharge

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Health First Hospital Discharge

Health First Hospital Dischargeadmin2023-02-10T13:37:15+00:00

Health First Discharge

If you are booking a discharge, please fill out the form below. However, if you would like to send us a message please click the button below to be taken to our communication page.

See Communication Page

Date of Service

MM slash DD slash YYYY

Which Hospital?

Booked By

Booked By: Name

First Last

Booked By: Phone Number

Booked By: Email Address

Who is responsible for payment?

Patient Information

Patients Name

First Last

Account Number(Required)

Patients Floor Number

Patients ER Bed Number

Patients Weight (lbs)

Patients Height

Patients Date of Birth

Trip Information

Destination Name

Destination Address

Destination Room Number (if applicable)

Destination Phone Number

Type of Trip

One Way

Round Trip

Type of Transport

Wheelchair

Stretcher

Ambulatory

Personal Oxygen

Yes

No

If Yes, How Many Liters Of Oxygen (5L Max)

Baker Act Transportation

Yes

No

Contact Precautions

Yes

No

If Yes, What Is The Precaution For

List any special equipment that must travel with patient

List any special belongings that must travel with patient

About

Stellar Transportation is the number one name for local non-emergency medical transportation services for handicap, elderly and stretcher patients. We also offer long distance transportation anywhere in the Florida, as long as your intended destination is at least 150 miles away. We are called Stellar Transportation for a reason—that’s exactly what we provide!

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Company Headquarters

Contact Information
301 E. Hibiscus Blvd
Melbourne, Florida 32901
Email: info@stellartransport.com
Phone: (321) 222-6222

The above contact information if for our headquarters in Melbourne, FL. If you are trying to contact one of our other locations you can find that information here: Click Here

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