Incident Report Request Form

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Incident reports are available to individuals directly affiliated with the incident for a fee of $27.00. To request a report, please complete the form below.

For any questions, please contact the Administrative Office at 916.933.6623.

Incident Reports do not include medical records. Medical information is documented separately in a Patient Care Report (PCR).

To request a Patient Care Report (PCR), please contact El Dorado County EMSA (Ambulance Billing) for assistance:

For medical records related to an incident after January 2020, call 1.800.906.6552 or email your request to records@webillems.com.
For records related to an incident prior to January 2020, call 530.621.7561 and leave a message, or submit your request through ChartSwap by calling 1.800.906.6552.

To receive a copy of your submission, please fill out your email address below and submit.
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