This is a form to submit a complaint regarding quality of care, fraudulent credentials or other misconduct by a healthcare provider. If you prefer to have this form mailed to you, please call 860-509-7975.
EMS Instructor Course Forms
Forms for EMS Instructors applying to conduct training courses.
For Initial Certification Training Programs:
For Recertification Training Programs:
EMS Provider Licensing & Certification ApplicationsPlease visit our Licensing & Certification page Opens in a new window Opens in a new window for more information and instructions to apply for certification and licensure for all clinical EMS providers. Below you will find forms for currently certified or licensed EMS providers.
EMS Organization Forms
Forms for organizations to apply for new or expanded services, PSAR designation, change in authorization, new vehicles, change in sponsor hospital, or to add authorized skills.Need for Service Application
These are forms for use by a hospital, municipality or other non-EMS organization.
Please Note: Adobe Acrobat Reader is needed in order to view and print the Portable Document Format (pdf) files.