Public Records Request

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The City Clerk’s Office handles Public Records Requests in compliance with California’s Public Records Act. Although persons in need of records are not required to fill out a Public Records Request Form, completion of the form makes the process more efficient. If you wish to complete a Public Records Request Form, please use the links below to submit your request.

Please contact the City Clerk’s Office at (650) 877-8518 if we might be of further assistance with respect to your Public Records Request.

 

For Public Records Requests pertaining to medical records, please include the following documentation:

  • HIPAA Authorization: This is required for release of records if you are representing the patient as an Attorney or family member.
  • Power of Attorney: This is required if you are acting on behalf of the patient who has either passed away or is incapacitated in any way. Please note that the Power of Attorney must specify that you are authorized to act on their behalf for medical reasons and can obtain documentation related to their treatment.
  • Birth Certificate:This is required if you are a parent requesting medical information for a minor.
  • Legal Guardian documents: If you are the legal guardian for a minor / special needs adult and are requesting medical information for the patient.

Please note that in some cases you may need one or more of the noted documents.

Additionally, all requests should contain the following details:

  • Full name of patient
  • Date of service or date range if requiring multiple records

Should you require billing information, please contact the appropriate billing company noted below.

For transports with a DATE OF SERVICE prior to April 1, 2016:

  • Intermedix         888-980-9223 (patients only)

For transports with a DATE OF SERVICE of April 1, 2016 through March 15, 2017:

  • Novato Fire Protection District         415-878-2641

For transports with a DATE OF SERVICE of March 16, 2017:

  • Wittman Enterprises      (800) 906-6552