EMD Field Feedback Report


Purpose: As a field care provider, to inquire about an EMS call with regards to  the EMD process; appropriate reductions or upgrades in response, concerns or  questions regarding EMD first responder care over the telephone, and recognition  of EMD practices which contributed to a positive patient outcome.

Date of Incident Time of Incident
Location/Address Run# or A#
Your Name Your Agency
Your Phone Your Shift
Narrative:

Our policy is to get back to you with feedback/response within 14 days of receiving your  inquiry. Please help us by being detailed in your narrative so that we may properly  educate or acknowledge your feedback with the dispatcher. We appreciate your interest  in our quality assurance process.

 

Download a PDF copy of the EMD Feedback Report