open records request

Fire Runs & Open Records Request Form

Please note: This form IS NOT for requesting protected healthcare information. Those requests need to be made with the proper signed HIPAA compliant paperwork through our business office.

* Indicates required field

Requester Name *

First

Last

Business/Organization Name (If Applicable) *

Are You a Media Organization? *

Yes No

Please provide us with a means to contact you. We must have a way to contact you (email preferred, for expediency), should responsive records become available.

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Complaint Statement

Is this request for an environmental study? *

Yes No

Type of Question *

911 Call/Fire Report Fire Inspection Report or Letter Permit Other

Date *

Response Location *

Line 1

Line 2

City

State

Zip Code

Country

Records Timeframe From and To *

Describe the specific record or records you wish to examine here or submit attachment with record description below: *

Upload File *

Max file size: 20MB

Submit

Fire Runs & Open Records Request Form

Contact

Headquarters

Connect With Us

Fire Runs & Open Records Request Form

Contact

Headquarters

​Connect With Us

Connect With Us