Incident Request Forms
The Fire Incident Request Form
The Fire Incident Request Form is required in order to obtain copies of an incident report. Record requests will be ready within five (5) working days of receipt of your request. Reports are provided free of charge to any individual involved in the incident. Others must purchase a copy of the report. You may fill out the report on-line then print and mail to:
Peoria Fire Department
Attn: Records Management - Fire
8401 W Monroe, Peoria, AZ 85345
Indicate on the form by checking the appropriate box whether you want the records mailed or whether you will pick them up at our office. If you wish them mailed, enclose a stamped, self-addressed envelope. Records will be ready within 5 working days of receipt of the request. Enclose a check payable to the "City of Peoria" for the amount required per report, as noted below.
$10 if the request is within 30 days of the incident.
$20 if the request is more than 30 days after the incident date.
You may also make the records request in person at the Fire Department Administration Offices at 8351 W Cinnabar, Peoria, AZ 85345
Download the Fire Incident Report Request Form (PDF)The EMS Incident Report Request Form
The EMS Incident Report Request Form is required in order to obtain copies of an EMS incident report. The EMS Report request form must be submitted in person at the Fire Department administrative offices, 8351 W Cinnabar Peoria, AZ. The only exception to presenting in person, is if the request form is accompanied by a court order mandating release of the record.
Medical records will only be released to the patient involved, unless:
- A court ordered subpoena is presented.
- A signed HIPPA Release Form and Power of Attorney is presented.
- The patient is a minor child, in which case the parent or guardian must present picture ID when the request is made.
- The patient is deceased, in which case the family member requesting the record must present a copy of the death certificate.
There will be no exceptions to these requirements. If you are submitting the request by mail, please send to:
Peoria Fire Department
Attn: Records Management - EMS
8401 W Monroe, Peoria, AZ 85345
Indicate on the form by checking the appropriate box whether you want the records mailed or whether you will pick them up at our office. If you wish them mailed, enclose a stamped, self-addressed envelope. Reports are provided free of charge to the patient. Others must purchase a copy of the report. Fees are as follows:
$10 if the request is within 30 days of the incident.
$20 if the request is more than 30 days after the incident date.
Enclose a check payable to the "City of Peoria" for the amount required per report. Records will be ready within five (5) working days of receipt of the request.
Request for EMS Incident Form
