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.
• EMS education programs.
• Designated trauma centers.

Complaints regarding licensed ambulance services must be filed with the county in which the service is based.

Complainant information
Your information will be kept confidential and not shared with anyone. We will contact you if we need additional information.
Your name
Your answer
Agency\organization
Your answer
Email address
Your answer
Phone number
Your answer
Alternate phone number
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
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