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EMS Complaint Form

  1. Big Spring Fire Department
  2. Emergency Medical Service Complaint Form
  3. Please complete and submit this form. You may also mail this form to Big Spring Fire in a sealed envelope addressed to BSFD, 1401 Apron Dr, Big Spring, TX 79720. If you do not know the information for a particular blank, please leave it empty. You may be contacted at a later date for additional information.
  4. Complainant Information
  5. Incident Information:
  6. Employee Information
  7. Whitness Information
  8. Witness #1
  9. Whitness #2
  10. Witness #3
  11. Complainant Statement
    INSTRUCTIONS: Please describe below in detail the incident about which you wish to complain. Be specific about persons involved and their actions. Use as many pages of the statement form as needed and remember to sign and date the last page.
  12. Complaint Made By
    NOTE: Complainants signing this government document are swearing and attesting that the information contained herein is true and accurate.
  13. Leave This Blank:

  14. This field is not part of the form submission.