How to Request Information from Ambulance New Brunswick

If you would like to know how your information is collected, used and disclosed by Ambulance New Brunswick, 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 Ambulance New Brunswick’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 Ambulance New Brunswick,
  • A copy of your own personal health information that was collected by Ambulance New Brunswick, or
  • A copy of someone else’s personal health information that was collected by Ambulance New Brunswick

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 ANB

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.

Forms can be submitted:

  • 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

 
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