How do I submit the EMS report request?

Email it to citysec@helotes-tx.gov, fax it to 210-695-2123, or mail it to the City Secretary at P.O. Box 507, Helotes, Texas 78023.

What must I include with my request?

Submit the authorization to use and disclose protected health information and a copy of identification. Provide the patient’s name, service date and time, incident location, and record details.

Are there fees for an EMS report?

The form states that fees apply if you request a copy of the EMS document or a certified document.

Helotes, TX · Bexar County

No notary required

Request for Emergency Medical Services Report

This form helps people request an emergency medical services report from the City of Helotes and provide the information needed to identify the record.

What this form is

Use this form to request a copy of an EMS report from the City of Helotes; the city also accepts requests in any written format. The request asks for contact details, patient name, service date and time, incident location, and information identifying the record. Include the required authorization to use and disclose protected health information and a copy of identification.

Who needs it

Anyone requesting an EMS report from the City of Helotes should provide this request, the required health-information authorization, and a copy of identification.

How to submit it

Email the request to [email protected], fax it to 210-695-2123, or mail it to City of Helotes, Attn: City Secretary, P.O. Box 507, Helotes, Texas 78023. Fees apply for copies and certified documents.

About notarization

This request and its health-information authorization are signed and dated without a notary; include the authorization and a copy of identification.

How to submit this form

1
Download The Form
Download the EMS report request form.
2
Complete The Request
Provide your contact details and the patient, service, incident, and record information requested.
3
Gather Required Items
Include the signed health-information authorization and a copy of identification.
4
Submit To The City
Email, fax, or mail the request to the City Secretary using the contact details on the form.

Frequently asked questions

Do I need a notary for the EMS report request?: No. The request and health-information authorization are signed and dated without a notary; include the authorization and a copy of identification.
How do I submit the EMS report request?: Email it to [email protected], fax it to 210-695-2123, or mail it to the City Secretary at P.O. Box 507, Helotes, Texas 78023.
What must I include with my request?: Submit the authorization to use and disclose protected health information and a copy of identification. Provide the patient’s name, service date and time, incident location, and record details.
Are there fees for an EMS report?: The form states that fees apply if you request a copy of the EMS document or a certified document.

Need something notarized?

This Request for Emergency Medical Services Report doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.