Contact for Report an EMS serious incident
Office of Emergency Medical Services - Ambulance Services
The Details of Report an EMS serious incident
What you need for 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.
How to report Report an EMS serious incident
- Download and complete the EMS Serious Incident Report Form l (DOCX)
- Scan and email the form to OEMS.SIR@state.ma.us.
- Fax any trip records that are part of the serious incident report to the Office of Emergency Medical Services at (617) 753-7320. Do not email trip records.