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    About This Form
    This form is intended for both employees and members of the public to confidentially report any complaints, concerns, or suggestions related to the operations of Maine Emergency Squad, Inc. This includes, but is not limited to:
    • Patient care or documentation concerns
    • Compliance or privacy issues (HIPAA, billing, or regulatory matters)
    • Safety or workplace environment issues
    • Ethical, professional, or conduct-related concerns
    • Suggestions for operational improvement
    All submissions are reviewed by the Administrative and Compliance Officers and are handled in accordance with our Compliance and Quality Assurance Program.
    You may choose to remain anonymous, or you may provide your contact information if you wish to receive a follow-up. Regardless of anonymity, every inquiry will be reviewed and, when appropriate, investigated or addressed.
    All information submitted through this form is strictly confidential and shared only with authorized members of the administrative team responsible for compliance, privacy, and quality assurance. Retaliation for good faith reporting of any concern is strictly prohibited under agency policy.
    By completing this form, you are helping us maintain transparency, accountability, and the highest standards of patient care and organizational integrity.
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