To share information about a grievance, complaint, or concern that you have about a licensed Emergency Services Professional (EMT/Paramedic) or Ambulance Service, please utilize this form to provide as much information as possible. When sharing information, think about the basics of "who, what, when, and where" to provide as much detail to describe your concern(s). Also, we provide a way for you to share pictures and other documentation supporting your concern(s).

The items indicated by a red asterisk* are required in order to complete your submission.