Fire and EMS Report Requests

EMS Records 

The Health Insurance Portability and Accountability Act (HIPAA) ensures patient information is protected. Frederick County, Maryland Division of Fire and Rescue Services is a covered entity under HIPAA’s privacy and security regulations and must follow these regulations when requests for EMS records are made. 

•    If you are requesting medical records or ambulance billing records from our Emergency Medical Services for yourself or for someone else, please go the Emergency Medical Services web page (https://www.frederickcountymd.gov/1119/Emergency-Medical-Services) and click on FORMS.  Click on the Patient Request for Access to Protected Health Information form found on that page to obtain a printable copy of the form.  You may also contact us by phone or email as noted below to ask us to send you request form by mail.  

•    Please note that our release of information requires that the patient sign the release form, except in the case of a minor child or a court-appointed guardian or other legally authorized representative.  (For example, a spouse or family member may not sign the form for the patient unless legally authorized or unless the patient is a minor child of the requestor.)  

•    Identification of the person requesting the records is required for all requests.  Include a copy of your valid government-issued identification with your completed request form.  For attorneys requesting records, please include a letter of representation signed by the patient, along with your identification.  For court appointed guardians or other legally authorized representatives, please include a copy of the signed documentation validating your authority to act on behalf of the patient.  Requests without accompanying documentation cannot be honored.  

•    Requests for records will be completed within twenty-one (21) calendar days or sooner, when possible.  If we cannot complete the request within twenty-one (21) calendar days, we will notify the requestor of the reason why there is a delay.

If there is any question on our part regarding the validity of any authorization or identification, or if the form is incomplete, we will notify the requestor that the request cannot be honored and why it cannot.  Resubmission of requests with the required corrections and/or documentation is permitted, and the date of request will be noted as the date of resubmission.  

Please send completed forms and identification documents via encrypted email to EMSdocrequest@FrederickCountyMD.gov , by fax to 301-600-1323, or by mail to:

Frederick County Division of Fire and Rescue Services
5370 Public Safety Place
Frederick, MD 21704

Contact Us

All inquiries/requests should be directed to:

Custodian of Records
Division of Fire and Rescue Services
5370 Public Safety Place
Frederick, MD 21704
(P) 301-600-3025
(F) 301-600-1323
Email Custodian of Records

You may submit your request in person, by fax, by email, or by mail to the address listed above.