Thank you for sharing your stories!

We know that ambulance services touch lives every day. Please help us shine a light on the impact of mobile healthcare in our communities by sharing stories from your patients. (Of course, please be sure to get their permission first! A sample HIPAA release is available for your use at http://ems.zone/hipaamedia).

We are looking for stories from all kinds of patients and their families, not just 911 response. Especially important are stories that show the human impact of EMS.

Have questions? Please contact ariordan@ambulance.org. Thanks again!

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* 1. Ambulance Service Details

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* 2. HIPAA Release Upload

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 3. Patient Information

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* 4. Patient of Family Member Story or Quote

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* 5. Photo Upload

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 6. Please check all that apply to this patient

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* 7. Anything Else We Should Know?

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