Law Enforcement Records Request Form REVISION IN PROGRESS
Beginning June 25, 2024, law enforcement agencies must provide court-ordered documents or other legally binding processes to compel PHI disclosure under the “Administrative Request” exception such as a court-issued subpoena, summons, warrant, or similar process.
Law enforcement officials must complete the Law Enforcement 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 law enforcement 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.