Complaints/Investigations

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 Applications

Please 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

Other Forms

These are forms for use by a hospital, municipality or other non-EMS organization.

 

Please Note: Some files are in Portable Document Format (pdf). You will need Adobe Acrobat Reader to view and print the information. For fillable pdf forms, you must download and save the form to your computer for the full functionalities to work.   Other files are in Microsoft Word or Excel Format (.doc or .xls).  You will need Microsoft Word and/or Excel to view and print this information.   

Get Adobe Acrobat Reader DC Opens in a new window Opens in a new window