Records Request Forms

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Hours of Operation

To pick up Medical. Fire or Billing Records:

Monday, Tuesday, Thursday, Friday

8:30 a.m. – 4 p.m.

Ambulance Billing/Balance Verification

Email: ets.pfd@phoenix.gov​ or Fax: (602) 534-4827

Please make sure you attach the ​patients medical authorization

​Please allow 15-45 business days for your request to be processed

TO OBTAIN PUBLIC RECORD PER CITY ORDINANCE S-36997 JULY 1, 2010:
Submit a written request form via fax, e-mail, in person, or by postal mail.  Please ensure that you provide the incident number, location of the incident, date, and time.    

Fire Prevention Inspection Records Request​

Including Inspections, Plan reviews, Permits, and Complaints

 Medical, Ambulance &/or Fire Records Request Form ​ ​(additional documentation required)

Itemized Billing Statements for Transports in an Ambulance, Records from Paramedics or EMS Reports

The release of medical records is governed by the Federal Health Insurance Portability and Accountability Act (HIPAA) and there are additional documentation requirements for Medical Records.

If you are requesting records and:

The patient is 18 years of age or older with one of the following:

• Requestor is the patient and has an original or a copy of a photo ID.
• Requestor has notarized authorization and a copy of a photo ID from the patient.
• Requestor has a notarized power of attorney for the patient.

If the patient is under 18 years of age, one of the following is required:

• Requestor has an original or notarized copy of the patient's birth certificate.
• Requestor has an original or notarized copy showing Court appointed guardianship of the patient.
• Requestor has an original or notarized copy of the patient's birth certificate or Court appointed guardianship papers and a notarized letter stating that the parents or guardian allow the requestor to have the information.
• If the patient is deceased a copy of the death certificate must be included with records request.