DCF Records Request Form

Representatives of the Department of Children and Families must complete the DCF Records Request Form and return it on your agency letterhead. This form may be faxed or mailed to the Pinellas County Ambulance Billing location.

For questions related to Department of Children and Family requests, please contact a Billing Services – Legal agent.

Ambulance Billing Services – Legal
Phone: 727-582-2052
Fax: 727-582-2021
P.O. Box 31074
Tampa, FL 33631-3074

If you are the patient, a patient representative, an attorney, or from another agency and are requesting Protected Health Information/Medical Records please visit the Request Medical Records for Ambulance Services page.