EMTS Branch Complaint Form
Use this form to file complaints about acts or practices related to state-regulated:

•    Emergency medical service providers (an individual)
•    Air ambulance services
•    Ground ambulance services
•    EMS education programs
•    Designated trauma centers

Sign in to Google to save your progress. Learn more
Complainant information
Your information will be kept confidential and not shared with anyone. We will contact you if we need additional information.
Your name
Agency\organization
Email address
Phone number
Alternate phone number
Address
City
State
Zip code
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of State.co.us Executive Branch.

Does this form look suspicious? Report