S-SV EMS Ambulance Patient Diversion Form

Instructions

Complete all pertinent sections of the form, and click the 'Submit' button at the bottom of the page to send the information to S-SV EMS staff & any additional email addresses you entered (a copy will automatically be sent to the 'Contact email' address entered below).

The S-SV EMS Duty Officer must also be notified by telephone for any diversion event:
• Primary: (916) 625-1702 (during business hours) or 916-625-1710 (after business hours)
• Backup: 530-245-6550 (SHASCOM Dispatch - ask for the S-SV EMS Duty Officer)
Note: If you select 'Internal Disaster' or 'Patient surge event', additional required data entry fields will be displayed