East Brentwood FD
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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
    Max file size: 20MB
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East Brentwood FD

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  • Home
  • About
    • Chiefs
    • Officers
    • Members
    • Commissioners
    • Apparatus >
      • Past Apparatus
    • History
  • News
  • Fundraising
  • Volunteer
  • Community
    • Fire Safety Tips
    • Links
  • Contact
    • Records Request >
      • PCR Request
      • Fire Incident Report Request
      • PCR and Fire Incident Report Request
  • Members