Patient Records

Request a copy of an ambulance patient care record.

Penwebems is committed to protecting the privacy and confidentiality of patient information. Patient care records contain Protected Health Information, commonly referred to as PHI, and may only be released in accordance with applicable privacy laws, agency policy, and proper authorization.

If you are requesting a copy of your own record, your child’s record, or records on behalf of another person, please complete the request form below.

Records Request Notice

Penwebems maintains administrative, physical, and technical safeguards to protect patient information. Members and employees receive privacy training and are expected to follow agency policies and procedures related to the handling of Protected Health Information.

Patient records cannot be released by telephone request. A completed records request must be submitted and reviewed before records can be released.

Under HIPAA, individuals generally have the right to inspect or receive a copy of their own protected health information when it is maintained in a designated record set. HHS describes designated record sets as including medical records, billing records, and other records used to make decisions about individuals.

Who Can Request Patient Record

Patient records may be requested by

Request Type	Examples
Adult Patient	An adult patient requesting their own record
Parent or Legal Guardian	A parent or legal guardian requesting records for a minor child
Authorized Representative	A person with proper written authorization from the patient
Legal or Administrative Request	A subpoena, court order, or other legally recognized request
Treatment or Payment Request	Requests related to treatment, billing, or payment purposes

Note:
Additional documentation may be required before records can be released, such as proof of identity, proof of guardianship, legal authority, or a signed authorization.

 

RECORDS RETENTION:

Penwebems retains patient care records according to agency policy and applicable record retention requirements.

Record Type	Retention Period
Patient care records for patients age 18 or older	7 years from the date of response
Patient care records for patients under age 18 at the time of response	7 years from the patient’s 18th birthday
Records subject to legal proceedings	Permanent
Call responses not involving patient contact or care	3 years

Notices of Privacy Practices