CITY OF PULLMAN AMBULANCE RECORDS
Patients who are treated and transported by City of Pullman Ambulance personnel may request a copy of their ambulance treatment record known as a Patient Care Report and other related documents in his or her file.
Patient Care Reports are medical records and as such they are protected under Federal and Washington State laws. City of Pullman Ambulance personnel follow strict guidelines to ensure confidentiality of the patient’s protected health information (also known as PHI). As healthcare providers, we are allowed to use and disclose patient health information for specific purposes without your authorization or notification. For details about our legal duties and privacy practices, please refer to the complete City of Pullman Ambulance Notice of Privacy Practices available on our website. If you prefer a paper copy, one will be mailed to you upon request.
Patients retain the right to protected medical records even after death. The patient’s designated personal representative or the legal executor of his or her estate has a right under law to access the patient’s records. What documentation is needed to make the request for a deceased patient’s records? A combination of the patient’s death certificate and a court document establishing estate executorship is sufficient to establish one’s right to the patient records.
To obtain records, the patient (or parent/legal guardian of minor-age patient) must submit a written request, or complete the Medical Records Request form provided below, stating the specific medical record requested, to whom and where the record should be released to, and daytime contact information for the person authorizing the release. We can provide you with our Authorization for the Release of Protected Health Information form upon request. The request should be accompanied by a good-quality photocopy of the signatory’s valid driver license or government-issued photo ID along with pertinent court documents if applicable. When a request for records is received by our office, we will contact the requester to provide the estimated release date and cost of copying and mailing the records. Records are released after prepayment of copying and mailing fees.
Records Requests can be submitted in one of three ways: In-Person; U.S. Mail or Fax. Please indicate whether the records will be picked up in person, faxed, or mailed through the U.S. Postal Service.
For further questions, please contact Medical Records Specialist Brenda Davison at (509) 338-3271.
City of Pullman Fire Department
Attn: Medical Records Specialist
620 S Grand Ave.
Pullman, WA 99163
Fax: (509) 332-4460
Click on the green box below to open fillable form:
Medical Records Request Form.pdf