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Request for Release of Incident Report Information

  1. Requester Information

  2. 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.

  3. 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.

  4. 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.

  5. Fee for Incident Information

    $20.00 (up to 10 pages – each additional page $.38) Fee will be collected at time of release of incident information/report. Note: Victims of crimes receive one copy free of charge.

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