Records Request

Records may be requested by completing the Patient Care Report Release Form. If you are requesting a record and you are not the patient, you must provide the applicable "Required Documentation" (below), or complete the Notarization page attached to the Patient Care Report Release Form. We ask that a valid photo ID be included with all requests.

Required documentation for request based on requestor.

• Attorney

  • All attorneys requesting records should use ChartSwap.

    • ChartSwap Referral Letter

    • ChartSwap user guide for attorneys

• Spouse

  • Healthcare Power of Attorney or Court-issued Letters of Administration & Death Certificate (if available)

  • or This Form Notarized

• Parent of Minor Child

  • Birth Certificate

  • or This Form Notarized

• Guardian

  • Court-issued Guardianship Papers

  • or This Form Notarized

• Executor/Administrator/Attorney in Fact-Court

  • Issued Letters of Administration & Death Certificate (if available)

  • or This Form Notarized

• Patient's Healthcare Power of Attorney

  • Copy of Healthcare Power of Attorney

Requests for records can be submitted through one of the following:

• Email to info@unionems.net

• Mail to Union EMS P.O. Box 633 Monroe N.C. 28111

• Schedule a time to pick up in person @ 980-993-7601