Request for Medical Records

Anyone requesting a patient care report or patient bills from us must either:

  1. Come to the PCFD administrative office in person with their ID to prove identity (if they are the subject of the record).
  2. Have the form notarized if they cannot come in person (again, only if they are the subject of the record).
  3. Have a valid, notarized power of attorney if they are requesting a copy of a patient care report or patient bills for someone other than themselves.
  4. Be a legal representative of the patient and send a HIPAA release form from the patient with their records request.

In some cases, PCFD may charge a fee for copies of records.

Completed forms should be emailed to recordsrequest@pcfd.org.

Questions? Please Call (435) 940-2511

Requester Information

The record or records you have requested are classified under the Government Records Access and Management Act (GRAMA). Your request will be addressed as soon as reasonably possible, but no later than 10 business days after receiving the written request. If we are unable to fill your request within this timeframe, we will notify you by phone or mail of the reason(s) and inform you as to the procedure for continuing your request. Below is the Utah State Code indicating how records governed by this act may be disseminated.

Utah State Code: 63G-2-2002. Access to private, controlled, and protected documents.

Records containing protected health information as defined in 45 C.F.R., Part 164, are governed by HIPAA (the Health Insurance Portability and Accountability Act) are not subject to GRAMA.

45 C.F.R., Part 164: Standards for Privacy of Individually Identifiable Health Information

A copy of this information should be retained for future reference. If you have any questions, please contact the Park City Fire District Office by calling 435-940-2511 8:30 a.m. – 4:30 p.m., Monday through Thursday.