Contacts
Mobile Integrated Health Care Program
The Details of File a Community EMS, MIH, or MIH with EDA complaint
What you need for File a Community EMS, MIH, or MIH with EDA complaint
Use the form below and provide as much detail as possible, including relevant dates, times, witnesses, equipment, events surrounding your complaint, and any corrective action you are aware of that has been taken to date.
Please note:
- If you are Community EMS, Mobile Integrated Health Care (MIH), or MIH with ED Avoidance (EDA) program, and this issue meets the definition of “serious incident” as defined in 105 CMR 173.100, please complete the MIH and Community EMS Programs Serious Incident Report Form.
- OEMS has no jurisdiction over billing complaints. For these issues, you may contact the Consumer Advocacy and Response Division of the Attorney General's Office.
How to file File a Community EMS, MIH, or MIH with EDA complaint
- Download and complete the MIH and Community EMS Programs Complaint Form to the best of your ability.
- Mail your completed form to:
Mobile Integrated Health Care Program
Department of Public Health
Attn: Compliance Unit
67 Forest Street
Marlborough, MA 01752
- Download and complete the MIH and Community EMS Programs Complaint Form to the best of your ability
- Fax your completed form to (617) 753-8170. Do not email this form.
Downloads for File a Community EMS, MIH, or MIH with EDA complaint
Open DOC file, 54.5 KB,
MIH and Community EMS Programs Complaint Form
(English, DOC 54.5 KB)