|Shari Cobb||Records Coordinator|
|Pam Wapniarski||Administrative Support Assistant II|
The Records Division develops, plans, organizes and coordinates the computerized records management system, 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 certificate or power of attorney documents, along with a letter of request and self-addressed stamped envelope.
Attorney Request:A request on letterhead indicating the patient's name, date, time and location of incident along with a Medical Authorization Release Form signed by the patient/power of attorney and a self-addressed stamped envelope.
Procedure for Requesting Records:
Full Incident Record Request (Use this form for patient records, fire investigation reports, fire investigation photos or a 911 recordings)
Mail your request and a self addressed stamped envelope to:
Mesa Fire Records/Technical Services
P.O. Box 1466 MS6060
Mesa, AZ 85211-1466
Medical information is protected by HIPAA rules and regulations. Reports will only be released to and/or with:
- Attorney's with a medical authorization release form
- Power of attorney documents
- 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 death certificate as well as a notarized signature
- Police agencies