Get Ca Fd136 2015-2025

The CA FD136 form is used to request the release of various fire, medical, and marine safety records from the City of Huntington Beach. This guide provides a clear and supportive framework to help you fill out the form online effectively.

Follow the steps to complete the CA FD136 form online.

1. Click ‘Get Form’ button to obtain the CA FD136 form and open it in your online editor.
2. In Section 1, choose the type of record you are requesting by marking the appropriate box for fire, medical, or marine safety records.
3. In Section 2, provide the date of the incident, location, and incident number as required.
4. Section 3 requires you to fill out your information as the requestor. Include your name or company, reference number, address, phone number, and the reason for your request.
5. Indicate your preferred method of release by selecting either pickup, US mail, email, or fax. If you select pickup, provide the name of your representative if it is not you.
6. If you are requesting medical records, read and sign the statement acknowledging that electronic transmission may not remain confidential.
7. In Section 4, if applicable, provide the patient information for medical record requests, including the patient's name and your relationship to the patient, as well as attach necessary documents.
8. For patient authorization, complete Section 5 by signing and dating the form, ensuring you understand the terms regarding the confidentiality of your records.
9. Select the appropriate option concerning limitations on the type of information to disclose.
10. After filling out all sections, review your entries for accuracy. Save your changes, download, print, or share the completed form as necessary.

Complete your CA FD136 form online today to ensure a smooth records request process.