General Records Request Form General Incident Request Form (non-EMS report request) Requestor's Full Name (required) Street Address (required) City (required) State (required) Zip Code (required) Email (required) Phone Number (required) Reason for Request (required) Can we send the report to the email address listed above? (required) Yes No If no, what format would you like the document(s) in? (please include an address if requesting paper copies of the documents) Your Signature (required) Confirm e-Signature Review Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signatures Date (required) There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
