Records Request Instructions
STEP # 1 – Fill out the Records Request Form and sign it:
Download and fill in all applicable sections in AFD’s Record Request Form
STEP # 2 – Attach Applicable Documents (For Medical Records Only):
A medical record is any record (i.e. fire report, medical report or 9-1-1 tape/CD) that is not redacted and contains protected health information about a patient.
For more information about AFD’s policy regarding patient privacy rights, go to: Notice of Privacy Practices.
If you are a patient in need of a medical record, be prepared to provide identification (government issued photo I.D.) when submitting the Record Request Form.
Third Party Request:
If you are requesting a medical record and you are not the patient, you must attach one of the following to the Record Request Form:
- A notarized HIPAA-compliant release (see 45 C.F.R.164.508 for required contents of release) signed by the patient
- A court order signed by a judge authorizing the release (45 C.F.R. 164.512).
*A subpoena alone, without either a HIPAA-compliant release or court order attached, is not sufficient to authorize release of a patient’s medical record.
If you are requesting a medical record for a deceased patient a death certificate and proof of executor of the estate are required.
If you are requesting a medical record for your child a birth certificate (of the child) and picture I.D. (of the parent) are required.
Fire Report with a Casualty:
In order to obtain a fire report with casualty information included, the above mentioned documents are required for the medical record.
STEP # 3 – Send the Signed Records Request Form and applicable documents to AFD's Records Management Services.
Send the form and applicable documents by mail or in person to:
Records Management Division
Albuquerque Fire Department
400 Roma Ave. N.W.
Phone: (505) 764- 6333
Fax: (505) 764-6360