Obtaining Ambulance Reports

Patient Records

Obtaining ambulance reports

If you or a family member was treated or transported by PFPD paramedics, you can request a copy of the Patient Care Report (PCR). The PCR documents the care provided, including patient assessment, treatment, vitals, and transport information.

PCR copies are commonly needed for personal records, insurance claims, legal matters, or coordination with your medical providers. Requests can be submitted in person, by mail, or by using the form at the bottom of this page.

Skip to request form ↓

How It Works

Request process

Prepare

Gather a signed authorization to release medical information and a copy of the requestor's photo ID.

Submit

Submit your request using the form below, in person at the Administrative Office, by mail, or by email.

Receive

Once verified, your PCR copy will be prepared and provided to you.

What You'll Need

Requirements

Required for all requests

Signed authorization — A written "Authorization to Release Medical Information" signed by the patient or a legally authorized representative (e.g. legal guardian, power of attorney, estate executor).

Photo ID — A copy of a government-issued photo ID for the person submitting the request.

Incident details — Approximate date of the incident and the patient's name, so staff can locate the correct report.

Legal documentation (if applicable) — If you are not the patient, include proof of legal authority such as power of attorney, guardianship order, or estate documentation.

How to Submit

Submission methods

Online Form

Use the form at the bottom of this page to submit your authorization and photo ID as attachments.

Include the patient name and approximate date of the incident.

In Person

Visit the PFPD Administrative Office with your signed authorization and photo ID.

Hours: Monday–Friday, 8 a.m. – 4 p.m.

23748 W 135th St, Plainfield, IL 60544

By Mail

Mail your signed authorization, a copy of your photo ID, and incident details to:

PFPD — Records Request
23748 W 135th St
Plainfield, IL 60544

By Email

Email your signed authorization and photo ID as attachments to:

plfd_fire@plainfieldfpd.org

Include the patient name and approximate date of the incident in the subject line.

Eligibility

Who can request a report?

The Patient

Any patient treated or transported by PFPD can request their own PCR. A signed authorization and photo ID are required.

Legal Representative

A legal guardian, person holding power of attorney, or executor of a patient's estate may request the PCR with proof of their legal authority and a signed authorization.

Insurance Company

Insurers may request records in connection with a claim. The request must include the patient's signed authorization or other documentation as required under HIPAA.

Attorney

Attorneys requesting records on behalf of a client should include the patient's signed authorization, proof of representation, and a copy of their photo ID. Contact the District for specific submission instructions.

Submit Online

Request your report

Before you submit

Use the form below to submit a records request for your Patient Care Report (PCR). You will need to attach a signed authorization to release medical information and a copy of your photo ID. Include the patient's name and the approximate date of the incident so staff can locate the correct report.

If you are requesting on behalf of someone else, also attach proof of legal authority (power of attorney, guardianship order, or estate documentation).

Incident Information

Patient First Name (required)

Patient Last Name (required)

Incident Location / Address

Date of Incident

Additional Comments

I am a legal representative helping someone obtain their Ambulance reports (required)

Yes

File Uploads

Photo ID Upload (required)

Authorization to Release Medical Information Upload (required)

Legal Authority Documentation Upload

Approval

Email Address (required)

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

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Records Request Contact

For questions about requesting an ambulance report, processing times, or required documentation:

(815) 733-7313 · plfd_fire@plainfieldfpd.org

Administrative Office · 23748 W 135th St, Plainfield, IL 60544

Monday–Friday, 8 a.m. – 4 p.m.

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