Critical Incident Stress Management (CISM)

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Members, Call the American Ambulance Association for Backup

AAA Critical Incident Stress Management provides onsite support for TEAMS overcoming trauma and grief at your ambulance service following a traumatic incident.

AAA understands EMS represents the best of humanity at the worst of times. Sometimes our people need help processing after a staff fatality, natural disaster, active shooter, traumatic accident, or other extremely stressful incident. AAA can help.

To return employees to healthy and productive functioning after a traumatic event, a licensed counselor will arrive at your location to provide clinically appropriate interventions. Our expert will guide employees and managers through their normal reactions to abnormal events. These specialists are trained specifically in work issues, management consultation, workplace violence, threat assessment and crisis management.

When a traumatic incident occurs, please complete the form below for access to timely and compassionate support onsite at your location. Clinical guidelines suggest that the best time to conduct a CISM session is 72 hours after the incident occurs.

CISM Request Form for AAA Members

Company Name*
Name of Person Submitting CISM Request*
First Last
Email of Person Submitting Request*
Phone of Person Submitting Request*
Date of Incident*
Please provide the date the traumatic incident occurred.
MM slash DD slash YYYY
Time of Incident
If available/relevant, please provide time of incident.

: Hours

Minutes

AM/PM
Incident Brief Title*
Ex: "EMT Killed in Ambulance Crash", "Staff Suicide", "Active Shooter Response"
Incident Description*
Include details about casualties, etc. If there are media stories about the incident, you can paste links here in addition to a brief description.
What Date and Time is CISM requested? (4 hour time block)*
Please note that clinical guidelines suggest that the best time to have a CISM session is 72 hours after the incident occurs. However, this is dependent on flight schedules, etc. AAA covers up to 4 hours of CISM (combo of individual and group). If possible, please provide a few timeslots.
Address Where Counselor Should Report*
Please provide the address of the actual location where the member would like CISM to take place. This location should have a place where the counselor can speak with the whole group, as well as a room with a door that closes for individual sessions.

Street Address Address Line 2 City State ZIP Code
Estimated number of CISM participants*
Name of Onsite Contact for Logistical Coordination*
First Last
Email of Onsite Contact*
Enter Email Confirm Email
Cell Phone for Onsite Contact*
Comments or Other Important Details
Phone
This field is for validation purposes and should be left unchanged.

Critical Incident Stress Management (CISM)

Members, Call the American Ambulance Association for Backup

CISM Request Form for AAA Members

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