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Event Reporting

“Patient Safety and Provider Recognition Program”

The EMS Event Reporting Program is a comprehensive Patient Safety and EMS Provider Recognition program. EMS Events may be reported through the chain of command or anonymously. The policy, forms and instructions are below. Questions and comments about this program can be sent to Craig Stroup, EMS QI Coordinator at

Reporting is encouraged by all who encounter an actual or potential patient event, potential safety event, system concern, or exemplary care delivered within the Contra Costa County EMS system. Please use the EMS Event Reporting Form to provide a concise description of the event. No patient names or other personal information should be reported on this form. A hard copy version of this form is available below in the "Resources" section and may be completed and submitted via fax (925-646-4379) if desired.

EMS Event Report Form



Contra Costa EMS
1340 Arnold Drive, Suite 126
Martinez, CA 94553
925-646-4379 fax
Office Hours: 8:00 am - 5:00 pm Monday through Friday