Request Medical & Billing Records
The San Francisco Fire Department maintains records of the medical care that we provided to our patients and records of bills for emergency medical services rendered.
Only Authorized Persons May Obtain Copies Of These Records.
Please follow the instructions for requesting records at the link below as it applies to you:
Medical Records:
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 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 the address below.
San Francisco Fire Department
Medical Records Unit
698 2nd Street
San Francisco, CA 94107
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 Records:
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 your client has been treated by the San Francisco Fire Department and you require a copy of your client's medical and/or billing records for legal purposes, you may do so by providing a legal subpoena or authorization using the SFFD Patient Authorization Form.
Download a copy of the form using this link:
Requests may be for either medical record, billing record, or both.
All requests must include applicable fees and proper documentation at the time of submittal, unless a fee is prohibited by law.
Incomplete requests will be subject to denial.
Please refer to the instructions below as it applies to your request.
Subpoenas for Medical Records
All subpoenas must include patient name, injury date and case number.
All civil subpoenas must additionally include clear documentation of Proof-of-Service that opposing parties have been served.
Subpoenas MUST be hand-delivered with fee payment to:
SFFD - Medical Records Unit
698 Second Street, Room 209
San Francisco, CA 94107
Please review your subpoena for thorough documentation prior to delivery and call the Custodian of Medical Records to arrange drop-off and pick-up times to ensure service efficiency.
For payment, please refer to the Fee Schedule below. Subpoenas received incomplete shall be subject to denial.
Patient Authorizations
Requests submitted must include a cover letter on your company's letterhead describing the records being requested, an authorization using the SFFD Patient Authorization Form and fee payment. The required authorization form must be completed properly, including patient name and injury date, and must be SIGNED BY THE PATIENT. Please mail your request along with fee payment to:
SFFD - Medical Records Unit
698 Second Street, Room 209
San Francisco, CA 94107
Please review your request for thorough documentation prior to delivery. For payment, please refer to the Fee Schedule below. Requests received incomplete shall be subject to denial. Please do not send via Registered Mail.
Witness Interview or Deposition
To request an interview with Fire Department personnel regarding your case (e.g., ambulance or engine crew members), please review the link below:
Subpoena Fire Department Members for Deposition or Court Appearance
Fee Schedule
Please include payment at the time of request and make checks payable to: SFFD - Medical Records Unit
| Record Type | Fee |
|---|---|
| Medical Record | $18.00 |
| Ambulance Bill | $18.00 |
| Medical Record AND Ambulance Bill (for same incident) | $24.00 |
| Retrieval-from-Storage Fee * | $27.00 |
* Requests for Medical Records regarding incidents which occurred on or before 12/31/2007 MAY be subject to the $27.00 Retrieval-from-Storage Fee in addition to the regular processing fee. If you have any questions, please contact the Custodian of Medical Records.