Report an EMS serious incident

Please note these instructions are for Ambulance Services to self-report serious incidents.

If you want to file a complaint about care you or someone else received by Emergency Medical Services (EMS) personnel, please follow instructions on the File a complaint with the Office of Emergency Medical Services page.

• Your Service ID number
• Date of incident
• Names and certification numbers of EMS Personnel involved in incident
• Trip record(s), number(s), and a copy of the trip record(s)
  • If faxing, attach a copy. If emailing serious incident report, fax the patient care report separately.
• If the incident involved a vehicle crash, fire, or theft, include the license place number and the primary garaging location
• Please notify your affiliate hospital medical director (AHMD). Your AHMD must participate in and review and the service's Plan of Correction and Preventability.