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1002 Church Hill Road, Pittsburgh, Pennsylvania 15205
Main Office Number: 412-242-7322 Main Fax: 412-787-2340
The EMS regulations, §1027.3(k) requires EMS agencies to report, in a form or electronically, to the appropriate regional EMS council, an EMS vehicle accident that is reportable under 75 Pa.C.S., and an accident or injury to an individual that occurs in the line of duty of the EMS agency that results in a fatality or medical treatment by a licensed health care practitioner.
The report shall be made within 24 hours after the accident or injury. The report of a fatality shall be made within 8 hours after the fatality.
This revised form has been adopted by the Pennsylvania Department of Health, Bureau of EMS to meet the requirements of the regulations.
This form should be sent to Amos Cameron (firstname.lastname@example.org) at EMSI.
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