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Requesting Your Own Records

MEDICAL RECORD:

If you have been treated by the San Francisco Fire Department and wish to obtain a copy of your medical record for health care purposes, please print out the Patient Request for Medical Record Form (PDF) provided at the link below.  Mail the completed form AND a photocopy of a picture ID card, such as your State driver's license or passport, to:

SFFD - EMS Division
Medical Records Unit
1415 Evans Avenue
San Francisco, CA 94124

Your medical record will be sent to you via US mail.  Requests received incomplete shall be subject to denial.  Please do not send via Registered Mail.

 

BILLING RECORD:

If you are requesting a copy of your medical bill to provide payment, insurance information, or correct billing information, please contact the Billing Department Customer Service Line.

If you have any questions regarding the procedures for requesting your own records, please contact the Custodian of Medical Records.

 

Patient Request for Medical Record Form (PDF)


Notice of Privacy Practices

 

Last updated: 7/26/2010 3:09:50 PM