City of Keller, TX
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Copies of medical records may be obtained through our billing agency, Emergicon.
- For Attorneys & Law Offices
If you are unable to locate the ambulance provider in ChartSwap, we recommend contacting the provider directly.
Record Requests:
Submit all record requests via www.chartswap.com, listing the EMS agency as the Provider. - For Patients
Billing Inquiries:
If you have questions about your bill, please contact: - Emergicon Customer Service Phone: 972-602-2060 ext. 1610
Medical Records Requests:
To request medical records for a specific date of service, please complete the following form: - Patient Records Request Form (PDF) If you cannot click this link it can be found on our website.
Once completed, submit the form along with a copy of your driver’s license via one of the methods below:
- Fax (Secure): 800-608-9457
- Mail: PO Box 180446, Dallas, TX 75218
- Email: records@emergicon.com
Please ensure that both the completed form and a valid state-issued photo ID are included in your request
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For Transplant Coordination, Tissue Donation, Crash Investigation, or Texas Trauma Registry Reporting
If you are requesting records for purposes such as:
- Organ or tissue donation
- Crash reconstruction or investigation
- Texas Trauma Registry submissions
- Transplant coordination
A member of our medical records team will contact you shortly.
Please include the patient’s name, date of service, and any supporting documentation (if available) with your request.
Have a Concern About EMS Services?
- How to File a Complaint with the Texas Department of State Health Services (TDSHS)
- Download or request the EMS complaint form from TDSHS.
- Visit the DSHS Enforcement Actions page to download the EMS complaint form. https://www.dshs.texas.gov/dshs-ems-trauma-systems/enforcement-actions
- Request it by calling (512) 834-6765
- You may also request the form by emailing: EMS_Complaint@dshs.texas.gov
- Submit your completed form by email, fax, or mail.
Texas DSHS, EMS Compliance
1100 West 49th Street, Austin, TX 78756
Email: EMS_Complaint@dshs.texas.gov
Fax: (512) 821-4510
Office Hours: Mon–Fri, 8AM–5PM CST
- Download or request the EMS complaint form from TDSHS.
- For help, contact the EMS Complaint Line at (512) 834-6765.
- Visit https://www.dshs.texas.gov for more information.
