Patient Records

Each patient that is evaluated or treated by Henrietta Ambulance requires a pre-hospital EMS chart to be completed by the crew member(s) rendering care. The chart is completed electronically and is stored securely for future access if needed. It contains information about the call location, date/time and other pertinent data, the patient’s demographics, medical history, details regarding the patient’s condition as well as any treatments or interventions performed by EMS prior to arrival at the hospital.

Medical records are maintained for a minimum of 6 years, or 3 years past the patients 18th birthday if the patient is a minor when treated.

In compliance with the HIPAA Privacy Act, the information contained within this chart may only be shared with those providing treatment, for payment purposes (insurance reimbursement, etc.) and for health care operations.

In order to request a copy of a patient’s pre-hospital EMS chart, you must follow one of the these processes:

  • Direct Request – Complete the “Patient Record Request” form (PDF download).
  • Court Order – Through the legal process, a subpoena may be submitted to us requesting a copy of a patient’s chart.
  • Legal Request (Lawyers) – Lawyers or legal agencies may request a copy of a patient’s chart by completing the “Patient Record Request” form (PDF download). These requests must first be approved by the patient or designee.

All requests for patient records will be processed within 5 business days from receipt by Henrietta Ambulance (some may take longer due to complexity). Per the NYS Public Health Law, a copy charge of $0.75 per page plus postage may be charged.

If you have any questions about patient records, please contact Captain Mark Philippy at mphilippy@hvaems.org or (585) 334-4190.