Public Information Request

To request a record, please fill out the request forms below:

Request for Public Records

Name of requestor(Required)

First Last

How do you want the records delivered?(Required)

Address

Street Address Address Line 2 City State ZIP Code

Incident date(Required)

Location and/or name of patient(Required)

Type of call(Required)

Medical aid

Fire

Other

If other, please describe

Record type(Required)

Medical (First 30 pages are $1.12 per page, additional pages are $0.84 each

Non-medical ($0.15 per page)

An additional charge of $25 may be charged for records requiring additional time.

I Declare under penalty of perjury of the State of Washington that I am(Required)

ENTER FULL NAME

This is the equivalent of a notarization under Washington law but avoids the hassle of getting your signature notarized.

Enter your full name as your signature