Request Records

At Maplewood Fire & EMS, there are three types of report you could obtain: Fire Report, EMS Report and Ambulance Billing Report. Almost anyone could request copies of reports for legal purposes, but the requirements are different for:

  • Patient
  • Third-party Requestor (such as: a family member, attorney, insurance claims agent)
In order to obtain copies of  reports, please click on one of the tabs below and follow all the instructions. If you have any questions or need assistance, please call 651-249-2801. Thank you.  
  1.    Medical Records -      I am the PATIENT       
  2.  Medical Records -     THIRD-PARTY REQUESTOR
  3. Ambulance Billing Report
  4. Fire Report 

A signed authorization is required in order to release private health information.

What You Need To Do: 

1. Complete the form: Authorization for Release of Protected Health Information. 
2. Required: Notarized signature.
3. Copy of your valid driver's license.
4. Drop off, mail or fax the completed form and documentation to the Maplewood Fire Department.

Address: Maplewood EMS
ATTN: Medical Record
1955 Clarence Street
Maplewood, MN 55109

Fax: 651-249-2809