Appendix G


Hampshire College Emergency Medical Services

IMPROPER DISPATCH FORM

CFS #: ____________________________________
HCEMS #: ____________________________________
Date:  ____________________________________
Dispatcher: ____________________________________
Security:  ____________________________________
EMTs: ____________________________________
In the space below, describe why you believe this call was dispatched inappropriately. This completed form should be delivered to the Director of Public Safety along with a copy of this call's run sheet.


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