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Medical release

Between the Health Information Protection and Accountability Act (HIPAA) and F.S. 401.030, EMS/Medical Records, the release of the Ambulance Run Report is very limited. In general, the release of the ambulance run report is limited to the patient or upon written request of the patient. In all of the following instances, the cost of a run report is $5 for each date of service requested and is payable by cash, check, money order or credit card.

Requesting records in person

Any patient can request copies of their Ambulance Run Report in person. It is suggested that the patient calls the Records Clerk so that the records can be copied prior to the patient's arrival. Please give the Records Clerk at least 24  hours notice. The patient can then pickup a copy of the Ambulance Run Report, during normal business hours, at:

112 Carswell Ave.
Holly Hill, FL 32117

The patient must have a picture ID and $5 for each run report requested in order to pick up the records. The patient will be required to sign for the records.

Requesting records by phone or mail

No medical information will be discussed with anyone, even the patient, over the phone. To request a copy of the Ambulance Run Report over the phone or by mail, the request must be made in writing. You must include your name, date of birth, address and phone number, the date you received ambulance service, the address where you would like the records sent, and your signature. In order for this form to be accepted, it must be notarized as to the signature and accuracy of the statement. You must also include $5 for each date of service requested.

Release to Law Enforcement or Other Non-Medical Person

The patient's Ambulance Run Reports can not be released to law enforcement or other non-medical personnel without a subpoena, POA or Authorization to Release Medical Records signed by the patient. This includes Attorney's of Fact.

Patient is deceased

If the patient is deceased the release of the Ambulance Run Report is done in accordance with the State of Florida Estate Laws. This means that only the Personal Representative (PR) of the estate can obtain copies of the Ambulance Run Report. If there is no PR then authority for the release of the medical records are as following (in this order):

  • Non-divorced spouse
  • Children (in order of age)
  • Parents

A Power of Attorney (POA) executed prior to the expiration of the patient is no longer valid once the patient expires. If their are no parents, then release of the Ambulance Run Report rests with the Probate Courts and a Court Appointed PR.

Incapacitated patient

A patient who is determined to be incapacitated and unable to give authorization for the release of the Ambulance Run Report may have the Ambulance Run Report Released to the guardian, POA, or next-of-kin in the following order:

  • Guardian/POA
  • Non-Ddvorced spouse
  • Children (in order of age)
  • Parents

Other circumstances

For other circumstances in which your Ambulance Run Report can or can not be released, please see the company's Privacy Notice.


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    123 W. Indiana Ave.
    DeLand, FL 32720
    (386) 736-2700

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