Public Records Request

Complete the form below to request a public record.

A copy of Lacey Fire District’s Public Records policy may be viewed here.

Requests for release of medical information require the completion of a Healthcare Records Request form.

Request for Public Record

Date(Required)

Name of Requestor(Required)

First Last

Requestor's Phone(Required)

Requestor's Email(Required)

Enter Email Confirm Email

Requestor's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Date of Incident(Required)

Time of Incident

Type of Incident(Required)

Upload completed Healthcare Records Request Form here:

Max. file size: 100 MB.

Address/Location of Incident(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Other Details

Provide any additional descriptive information about the the incident here.

Other Non-Incident Related Information Requested

If you are looking for a public record that is not incident related, please provide details here.

Enter Your Legal Name Here(Required)

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