Request copies of patient care records. All requests are handled by mail after the requestor's identity is confirmed.
The Ravena Rescue Squad handles all information requests by mail after confirming the requestor's identity. We are committed to protecting the security of personal health information in accordance with HIPAA and applicable New York State laws and regulations. Choose the form below that matches your situation, complete it, and return it to us at the address provided on the form.
Official OCA Form No. 960 for law enforcement and attorney requests, signed by the patient.
Request your records in person. A valid photo ID is required for identity verification.
Request your records by mail. The form must be notarized before submission.
Your protected health information is handled in accordance with the Health Insurance Portability and Accountability Act (HIPAA). You have the right to access, amend, and request an accounting of disclosures of your medical records. For full details on how we collect, use, and safeguard your information, please review our HIPAA Notice of Privacy Practices →
If you have questions about a records request, please contact us at info@ravenarescue.net or 518-756-2096.