PCR and Fire Incident Report Request
Both Forms by Mail

To request both forms by mail, please follow the directions below:

1. Completed Authorization For Release of Health Information Pursuant to HIPAA (OCA Official Form No.: 960). The form can be found here.
2. A completed Fire Incident Report Request Form.
3. A $30.00 check made payable to: East Brentwood Fire Department. 
4. Mail to:

East Brentwood Fire Department
Attention: Records Request
26 Fulton Street
Brentwood, NY 11717

Both Forms by Fax

To request both forms by fax, please follow the directions below:

1. Completed Authorization For Release of Health Information Pursuant to HIPAA (OCA Official Form No.: 960). The form can be found here.
2. A completed Fire Incident Report Request Form.
3. Fax to: (631) 231-5670
4. A $30.00 check made payable to: 

East Brentwood Fire Department
Attention: Records Request
26 Fulton Street
Brentwood, NY 11717

Both Forms Online

To request both forms online, please follow the directions below:

1. Completed Authorization For Release of Health Information Pursuant to HIPAA (OCA Official Form No.: 960). The form can be found here.
2. Completed Fire Incident Report Request Form.
3. Upload the forms below
4. Pay online