Information Requests

How to Request Information from EM/ANB

If you would like to know how your information is collected, used and disclosed by EM/ANB, please view our Privacy Statement.

If you would like to request information or submit a request for correction to information, please see below and complete and submit the appropriate form. All requests will be processed in accordance with the Right to Information and Protection of Privacy Act and the Personal Health Information Privacy and Access Act as applicable. The Acts are available on the Government of New Brunswick website.

If you have any questions please do not hesitate to contact EM/ANB's Privacy & Risk Consultant at 506-872-6594.

General Information Requests

Complete this form if you are requesting:

  • General information, data or other records under the Right to Information and Protection of Privacy Act that you believe would be under the custody or control of EM/ANB,
  • A copy of your own personal health information that was collected by EM/ANB, or
  • A copy of someone else’s personal health information that was collected by EM/ANB*.

*Note – you will need to fill out a Substitute Decision-Maker Declaration form (below), have the individual whose information you are requesting complete an Authorization to Release form (below), or provide other proof that you are legally permitted to receive a copy of the person’s information.

Request for Investigations

Complete this form if you are requesting information as part of an investigation (law enforcement, family/social services, WorkSafeNB, etc.)

Request for Correction

Complete this form if you would like to request a correction to a record of personal information or personal health information held by EM/ANB.*

*Note – if the information that you are requesting to correct is not your own, you will need to fill out a Substitute Decision-Maker Declaration form or provide other proof that you are legally permitted to request a correction of the other person’s information.

Substitute Decision-Maker Declaration

Complete this form if you are acting on behalf of a person who is incapable of consenting to the collection, use or disclosure of their personal health information and are permitted to do so as described in the Personal Health Information Privacy and Access Act.

Patient Authorization to Release PHI

Complete this form if you wish to authorize the disclosure of your information to another individual; or Have the applicable patient/individual complete it if you wish for them to authorize their information be released to you.

Template Letter for Coroners

Complete the applicable sections in the attached letter if you are a Coroner investigating a death in New Brunswick.

Completing and Submitting Forms

If desired, you may complete most of the form on your computer, but for any request involving personal information or personal health information the form must be printed and signed prior to being submitted.

Requests for General Information about EM/ANB (Right to Information Requests) 

Via facsimile to (506) 872-6570

Via e-mail/scan to e-mail to rti@ambulancenb.ca

Via regular mail or in person:

Attn: Privacy & Risk Consultant
210 John St., Suite 101
Moncton, N.B.
E1C 0B8

Requests for Personal Health Information (or corrections thereto) related to ambulance service 

Via facsimile to (506) 872-6570

Via e-mail/scan to e-mail to rti@ambulancenb.ca

Via regular mail or in person:

Attn: Privacy & Risk Consultant
210 John St., Suite 101
Moncton, N.B.
E1C 0B8

Requests for Personal Health Information (or corrections thereto) related to extra-mural service 

Via regular mail or in person to the Manager of the applicable extra-mural unit