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Request for Release of Incident Report Information

  1. Requester Information
  2. Please attach a photocopy of the requesting party's identification card with photograph along with this form.

  3. Protection of Patient Information
    The City of Napa Fire Department makes every effort to protect private health information (PHI) of individuals that the department provides services to. The release of this information can only occur with the written authorization of the patient, a representative authorized by the patient, or by court order.
  4. Incident Information
    To better allow us to process your request, please indicate on this form the reason for your request and the type of incident information you want to receive.
  5. You will be contacted by a Fire Department representative within one (1) week of receipt of this request form, you will be notified as to the status of your request.
  6. Fee for Incident Information

    $25.00 (up to 10 pages – each additional page $.39) Fee will be collected at time of release of incident information/report. Fee must be payable to the City of Napa via check or money order. Note: Victims of crimes receive one copy free of charge.

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  8. This field is not part of the form submission.