Follow the steps to complete the CA EMS Form 6102A online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. In Section A, start by indicating the type of occurrence. Choose from the following options: Communications, Base Hospital Operations, Policy Violation, or others. If you select 'Other,' provide a detailed explanation on a separate sheet.
3. Complete the Incident Information fields. Input the incident location, date, and time of the occurrence. Provide the incident number, if available.
4. Fill in your personal details as the individual completing the form, including your name, employer, level of certification or license, certification number, work phone number, and cell phone number.
5. Document the names and agencies of any involved parties. Include a summary of the event. Use additional pages as necessary to provide a comprehensive overview.
6. Offer recommendations based on the incident. This section allows you to give your insights or suggestions regarding the occurrence.
7. Sign the form and date it to ensure it is officially completed.
8. If you are the CQI Coordinator, add your recommendations in Section B and provide your signature. Ensure all required documents are attached, such as EMS Form 6012 and any relevant patient care reports or records.
9. Review the completed form for accuracy and clarity before submission.
10. Once satisfied, save your changes. You can download, print, or share the form as necessary.

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