Children's Safety Initiative Anonymous Reporting System

This submission form is completely anonymous and encrypted. Please do not share identifying information.

Thank you for using the Children's Safety Initiative EMS Anonymous Submission Form. The purpose of this system is to report close calls and medical or treatment challenges that occur in the pre-hospital care of children, and to provide suggestions to prevent future challenges from occurring.

Your privacy is critical. Please do not share any criminal activity committed by a healthcare professional; we are required by law to report these events, even if submitted anonymously. Please do not include any personally indentifiable information in order to protect patient and provider privacy.


Submit Event Details

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This submission will be permanently deleted and cannot be recovered. Are you sure?