Public Records Request

To submit a public records request with the Fairhaven Fire Department please fill out the form below. Please note that there may be a fee associated with specific requests. This form is for public records request only. EMS patient care report requests must be submitted via mail with a patient signed HIPPA form and a $20.00 fee.

Date of Incident

Name of Person Requesting

First Last

Name of Involved Party

If different than person requesting

Releationship to Involved Party

Self, lawyer, family member, other

Phone

Address

Street Address City State ZIP Code

Type of Incident

Additional Detailsr

Public Records Request

Fairhaven, Massachusetts Fire Department