Emergency Services Experience Form

Emergency Services Experience Form

Please note that all responses are kept strictly confidential and will not be shared outside of Health Choice Maine’s leadership and legal team. (If you prefer to answer these questions by phone, you can do so by calling 207-200-8490.) See our Save Maine’s EMS System page to learn more about how we are using these responses.

Did you or someone you know need emergency medical services in Maine between August 2021 and the present?
What type of event caused the need for medical services?

Contact Information

Name
Name
First
Last
Would you like to join our mailing list and be kept up-to-date on our efforts?
Is it OK for Health Choice Maine to contact you if we have further questions?
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