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CCFD HIPAA Release Form
Submit this form to request medical reports for incidents
[[Fee Schedule:]]
The Clark County Fire Department (CCFD) Custodian of Records will process request for reports.
Please be advised fire incident and medical reports will be processed within 30 days of request. We will ensure that each request will be addressed in a timely manner.
You will be notified once your incident report is ready for pickup. Report requests can be delivered either by fax, email or it can be picked up at the Clark County Fire Department Administration Office at 575 E. Flamingo Rd., Las Vegas, NV 89119 from 9 a.m. to 2 p.m., Monday through Thursday.
[[EMS Report and 911 Audio Recording Requests]]
For EMS report or 911 Audio recording, a notarized HIPAA release is required prior to releasing any information and /or records to anyone other than the patient.
[[Billing]]
For billing and balance information, if your client was treated and transported by the Clark County Fire Department, please register and request the billing statement via Chartswap, https://www.chartswap.com/record-requestor-solutions/faq/. For questions about billing, please email them at info@chartswap.com. If your client was treated and transported by a private ambulance, please contact the private ambulance company who responded to your client’s incident.
Thank you in advance for your patience. We will get back to you with your request.
[[Document Destruction Policy]]
As per NRS Chapter 450 B, reports and other records documenting fires, emergency medical incidents, and fire related investigations will be retained for six (6) years from the date of the incident.