For EMS use only!To send information to the Emergency Dept. Director and the Emergency Medical Director at Upland Hills Health, FILL OUT THE FORM, and SUBMIT.

Fields marked with an asterisk (*) are required.

  • MM slash DD slash YYYY
    (Someone from our staff will reply within five business days)
  • EMS Information
  • * All patient information is sent to a service's training officer. Please check with him/her for follow-up information.
  • Transport Information
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • :
  • Please answer the following question regarding your interaction with the ED
  • This field is for validation purposes and should be left unchanged.

Why Choose Upland Hills Health?

Patient-First Care Every Patient. Every Time.

We are committed to providing the safest and best possible experience for every patient that enters our clinics, our hospital, our nursing and rehab center, our medical equipment store, or who invites us into their home through Home Care or Hospice services.

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