Records Request

Request a copy of a Forest Hills Volunteer Ambulance Corps patient care report.

Use this form to request a copy of an FHVAC patient care report (PCR). You'll provide details about the transport and upload documents so we can verify identity and authority to receive the records.

Records are released only to the patient or someone legally authorized to act on their behalf.
Fees: a patient requesting their own records pays $0.75 per page (billed after); attorney and insurer requests pay a $50 flat fee at submission (plus a 4% card processing fee).
You'll get an email confirmation, and we'll follow up if anything further is needed.

About you

Your full legal name *Your relationship to the patient *Mailing address *

Email *Phone

Patient & transport

Patient's full name *Patient's date of birth

Date of transport *Approximate time

Pickup / incident location Destination (hospital)

Incident / run number (if known) Patient address at the time

Reason for the requestAny other details that help us locate the record

Supporting documents

PDF or image files. We verify identity and authority before releasing any records.

Select your relationship to the patient above to see which documents are required.

Government-issued photo ID

Driver's license, passport, or other photo ID of the requester.

Signed HIPAA authorization

A completed, signed authorization from the patient (required for attorney / insurer requests).

Proof of authority / relationship

e.g. power of attorney, guardianship order, healthcare proxy, birth certificate, death certificate + letters testamentary.