Responders In Action

Responder in Action.
When you use your skills as an Emergency Responder to care for an injured or ill person, we'd like to hear about it. The incident need not be dramatic, involve life-threatening condition or necessarily have a favorable outcome. Sharing your story motivates and encourages others to use their skills and provide assistance in emergency situations. This information is also useful to monitor and gauge the effectiveness of Emergency First Response training and assist in future program development.

After submitting your story, you will be redirected to the main page and will be sent a copy of your story at the email address you have provided below.

Name:
(last) (first) (mi - optional)

Address:

City:

State/Province:

ZIP:

Country:

Email:

Phone:

Date of last EFR certification or recertification course :
(Day/Month/Year)

Name of your EFR Instructor/Trainer:

Emergency First Response Instructor No. (if applicable):

Location of Incident:

Date of Incident:
(Day/Month/Year)

Description of Incident:

Responder in Action. When you use your skills as an Emergency Responder to care for an injured or ill person, we'd like to hear about it. The incident need not be dramatic, involve life-threatening condition or necessarily have a favorable outcome. Sharing your story motivates and encourages others to use their skills and provide assistance in emergency situations. This information is also useful to monitor and gauge the effectiveness of Emergency First Response training and assist in future program development. After submitting your story, you will be redirected to the main page and will be sent a copy of your story at the email address you have provided below.
Name:	(last) (first) (mi - optional)
Address:
City:
State/Province:
ZIP:
Country:
Email:
Phone:

Date of last EFR certification or recertification course : (Day/Month/Year)
Name of your EFR Instructor/Trainer:
Emergency First Response Instructor No. (if applicable):
Location of Incident:
Date of Incident: (Day/Month/Year)
Description of Incident: