Medical Records Request
To request medical records for a specific date of service, please complete the following form:
📄 Patient Records Request Form (PDF)
Once completed, submit the form along with a copy of your driver’s license via one of the methods below:
- Fax (Secure): 800-608-9457
- Mail: PO Box 180446, Dallas, TX 75218
- Email: records@emergicon.com
Please ensure that both the completed form and a valid state-issued photo ID are included in your request.
For Attorneys & Law Offices
If you are unable to locate the ambulance provider in ChartSwap, we recommend contacting the provider directly.
Record Requests:
Submit all record requests via www.chartswap.com, listing the EMS agency as the Provider.
Billing
If you have questions about ambulance billing, please contact Emergicon at:
Email: questions@emergicon.com
Phone: 877-602-2060 or 972-602-2060
Bills can also be paid online at www.emergicon.com
Always dial 911 for medical emergencies.