Cortez Fire Protection District — Public Records Request Acknowledgment

The Cortez Fire Protection District ("District") complies with the requirements of the Colorado Open Records Act (CORA), the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and all other applicable laws regarding the production and release of public records. This includes compliance with legal provisions specifying when the District must, may, or cannot produce public records, as well as any applicable fees for such production.
A complete copy of the District’s Open Records Request Policy and associated fees can be found on the District’s website: https://cortezfire.com.
By signing below, I acknowledge the following:
I have had the opportunity to review the District’s Open Records Request Policy and fee schedule.
I understand that fees may be assessed for the production and/or delivery of the records I am requesting.
If requested by the District, I agree to pay all applicable fees prior to the release of the requested records.

PUBLIC RECORDS REQUEST

Name

First Name

Last Name

Date

YYYY

Address (required for mailed request)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Detailed Message

If possible, please include: (a) type of record; (b) date or date range; (c) specific subject matter; and (d) names of persons or locations. If this is a request for a Fire Incident Report, please also include the (e) incident number and (f) incident address, if known. Attach additional pages if needed.

Medical Information Release

Do you have an authorization to release medical information? (if so, please attached below)

Yes

N/A

Preferred Delivery Method

Email (provide email above)

Mail (additional fees)

Pick up / View in Person (during business hours)

Disclaimer

*I understand that records sent by email will be sent through UNENCRYPTED EMAIL THAT IS NOT SECURE and there is a risk that the records could be seen by a third party during electronic transmission, while in electronic storage, and/or upon completed delivery. The District is not responsible for unauthorized access of Protected Health Information (PHI) resulting from the emailed transmission, or for safeguarding PHI upon delivery.

Cortez Fire Protection District — Public Records Request Acknowledgment

PUBLIC RECORDS REQUEST

Cortez Fire Protection District

Helpful Links: