Records
Medical and/or Fire Reports:
Shari Cobb
Records Coordinator
Pam Wapniarski
Office Assistant
480-644-3526
The Records Division
develops, plans, organizes and coordinates the Computerized Records Management,
retention, retrieval, storage, and disposition functions for the Fire
Department. They also communicate with the general public, other City
employees, and representatives of public, city, state, county, and federal
agencies in providing information, answering inquiries, and responding to
sensitive requests.
Medical Report Release:
These records are confidential and require a notarized signature of
the patient. In the event of a death, the next of kin may obtain these
records if they can produce a copy of either the death/birth certificate
or power of attorney papers, along with a letter of request and
self-addressed stamped envelope.
Attorney Request:
Letterhead request indicating the patient's name, date, time and
location of incident along with a Medical Authorization Release Form
signed by the patient/next of kin and a self-addressed stamped
envelope.
Procedure for Requesting Records:
Please complete the Incident
Record Request form and mail your request and self addressed stamped envelope to:
Mesa Fire Records/Technical Services
20 E Main St, Suite 650
P.O. Box 1466
Mesa, Az. 85211-1466
Medical information is protected by HIPPA rules and regulations.
Reports will only be released to:
- Patients with a notarized signature of the patient.
- Attorney's with a medical authorization release signed by the patient
- Power of attorney papers
- For parents of minors: must have a copy of birth/death certificate as well as a notarized signature.
- Spouses or next of kin without power of attorney; copy of birth/death certificate as well as a notarized signature
- Police agencies - waiver signed by the patient
- Subpoena's
Fire and Medical Records Inquiries
Please call:
Mesa Fire Department Records
(480) 644-3526
Monday Friday (excluding holidays) 7:00am-6:00pm
To help facilitate your request, please be prepared to provide the
incident date, type, time and location. This will allow us to
obtain your incident number to complete your request process.
Normal requests are processed within 48 hours, but may take longer
in some instances depending upon the type and number of reports
requested.
Cost for Records:
1-6 pages
no charge
7-50 page
$5.00, $.20 each page over 50 pages
CD's:
$5.00 for Investigative Photos
$5.00 for 9-1-1 tapes
Requests for large quantities of records may require the
addition of clerical staff time charges to collect and process
information.
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