EMS Records Request and Authorization Form

Use this form to request copies of Stratford EMS records, including patient care reports, billing, dispatch and 911 audio records. It can be used by patients, parents or guardians, legal representatives, healthcare providers, insurers, attorneys and agencies. If you’re requesting records for someone else, include proof of your authority to receive them. Routine electronic copies for patients are normally free. Questions? Call (203) 385-4060.