Records Request FormFirst Name (required)Last Name (required)Company/Agency NamePhone Number (required)Email Address (required)Mailing Address (required)Preferred method of delivery (required)FaxMailPick-UpType of record requested (required)If you are requesting at fire report or medical chart, are you the patient or property owner?YesNoIf you are not the patient or property owner, please list your relationship to the patient or property owner.Date of Incident or Meeting (required)Location of Incident or Meeting (required)There was a problem saving your submission. Please try again later.Please wait while your submission is being saved...Submitting...SubmitThank you, your submission has been received.Your resquest will be responded to within five days.Your request may be subject to a records request fee. This fee is based on cost recovery. All fees are due prior to the public request documents being released.