*NOTICE of Delay in Medical Record Production*

Acadian Ambulance Service has always worked to ensure the safety and health of our community; it is the very core of what we do every day. Due to the spread of COVID-19 and the recommendations of all federal, state and local officials for the public to self-quarantine if possible, we have made the decision to limit our office staff to only essential personnel and those who are able to work remotely from home.

Please be aware that as of 04/17/2020, there will likely be a delay in the production of medical records. We will have a limited staff who will be focused on those urgent requests that originate from patients, healthcare facilities, law enforcement, coroner’s office, LOPA and other state or federal agencies. Of those requests that we are able to fulfill, we may be limited to electronic production, so if you fall into one of the above listed categories, please be sure to provide an email address or fax number, as that will be our primary means of production during this time.

We sincerely apologize for any inconvenience that this temporary change may cause and fully intend to get back to our normal processes and workflow as soon as possible. Thank you.

Requesting Medical Records

Your Privacy Comes First


A patient, or his/her legal representative, may inspect and/or obtain a copy of their medical records. Acadian Ambulance requires a completed and signed Consent to Release Health Information form before releasing any documents to anyone, including the patient.

To request medical records or pay for previously requested records, please read the instructions below.

How to request a copy of your medical records

Print and complete the Consent to Release Health Information form. If you have issues with the fillable form document, click here to download a printable version of the form.

The release form must be completed, dated and signed.

Email form to:

Mail form to:
Acadian Ambulance Service, Inc.
P.O. Box 98000
Lafayette, LA 70509
Attn: Medical Records Dept.

Fax form to:
Attn: Medical Records: Release of Information


In Person:
2916 N. University
Building G
Lafayette, LA 70507

Monday – Friday, 8:00 a.m. – 4:00 p.m. CST
Closed on holidays

Click below to pay for requested medical records.

NOTE: You must have a copy of the medical records pre-payment invoice in order to make a payment.

Medical Record Payments