EMS Billing/Medical Record Request

Converse Fire Department uses a third party billing company called Emergicon. This company handles all inquires regarding billing and requests for reports. If you have any questions regarding your bill, please contact Emergicon at 877-602-2060.

To request medical records, please download, complete, and submit the Emergicon Patient Records Request Form.

• Fax the request (secure and direct) to 800-608-9457

• Mail the request to: PO Box 180446, Dallas, TX 75218

• To email a request, we need to create a secure, encrypted email channel to receive your form. Please email records@emergicon.com with general information that you need to request records, and you will receive a secure email from us to use for the request process. Please do not send the completed request form using this email.

• Call 972-602-2060 ext. 1611 if you need help. Se habla Español.

If you are an attorney, please submit your request via Chart Swap with the EMS service as the Provider.