Western Berks EMS strictly follows patient privacy laws:
Patients
Patients and parents or guardians of minor patients may receive a copy of their patient care record (PCR) in person at the Western Berks EMS Main Station:
2506 Belmont Ave.
West Lawn, PA 19609
For deceased patients, the person listed at “Informant” or “Surviving Spouse” on the death certificate may receive a copy of the decedent’s PCR.
Required:
- Legal photo ID
- Completed Authorization for release of protected health (link) (form may be completed in the office).
- If deceased, the original death certificate is required. We’ll make a copy of it and return it to you.
Alternatively, patients may receive a PCR copy via mail by sending a Notarized Authorization for Release of Patient Record form via U.S. Mail.
Legal Designee of Patient
The legal Designee of the Patient may receive a copy of the PCR in person at the business office with a legal document granting authority. The family relationships do not qualify as the legal designee of the patient.
Required:
- Legal photo ID
- Legal document granting authority (Power of Attorney, executor of will/estate, death certificate, etc.)
- Completed Authorization for Release of Protected Health Information
Alternatively, a designee may receive a PCR copy via mail by sending a Notarized Authorization for Release of Patient Record form via U.S. Mail and a photocopy of the legal document granting authority.
Law Offices
Law Offices may receive a copy of a PCR with a Notarized Authorization for Release of Protected Health Information.
Judge Signed Papers
Judge-signed papers (court orders, warrants, etc.) allow the release of PCR without other documentation.
Western Berks Ambulance
2506 Belmont Ave
West Lawn, PA 19609
PH: 610-678-1545