BREMSS Regional CQI Template

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Contact information

First name *

Last name *

Email *

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Mobile Phone *

Job title *

Service or Agency EMS Coordinator

Check this box if you are the designated EMS coordinator for your service or agency.

EMS Service Level *

Company name *

EMS Region *

Select the EMS region in which your service or agency is located.

County *

Select the county in which your service or agency is located.

Service Medical Director *

If you are a non-licensed service or considered a BLS service and you do not have a service medical director you may enter Not Applicable

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body, html { margin: 0; padding: 0; font-family: 'Open Sans', sans-serif; overflow: hidden; } * { box-sizing: border-box; } .container-404 { background: url('https://online.bremss.org/images/manager/errors/ConferenceRoom_optimized.jpg'); background-repeat: no-repeat; background-size: cover; height: 120%; width: 100%; position: relative; background-position: 0% 50%; z-index: 9999999; position: absolute; top: 0; left: 0; right: 0; bottom: 0; } .content-404 { background: rgba(255, 255, 255, 0.97); text-align: center; width: 600px; position: absolute; top: 50%; left: 50%; margin-left: -300px; margin-top: -230px; border-radius: 2px; box-shadow: 0 3px 6px rgba(0, 0, 0, 0.16), 0 3px 6px rgba(0, 0, 0, 0.23); color: #454545; padding: 15px 30px; animation: fadein .8s ease-out 1; animation-fill-mode: forwards; animation-delay: 0.1s; } .logo-idloom-404 { position: relative; top: 0px; opacity: 0; animation: position .5s ease-out 1; animation-fill-mode: forwards; animation-delay: 0.2s; } .logo-idloom-404 img { width: 180px; max-width: 100%; } .content-404 h2 { font-size: 18px; margin: 40px 0; position: relative; top: 0px; opacity: 0; animation: position .5s ease-out 1; animation-fill-mode: forwards; animation-delay: 0.4s; } .content-404 h3 { position: relative; top: 0px; opacity: 0; animation: position .5s ease-out 1; animation-fill-mode: forwards; animation-delay: 0.6s; font-size: 16px; margin-top: 40px; } .content-404 a { text-decoration: none; color: white; } .content-404 h3>a, .content-404 p>a { color: #1ebae2; } .content-404 h3>a:hover, .content-404 p>a:hover { color: #1094b5; } .content-404 .btn-back-404 { max-width: 180px; width: 80%; padding: 10px 5px; border-radius: 2px; box-shadow: 4px 4px 8px rgba(0, 0, 0, 0.16), 3px 4px 18px rgba(0, 0, 0, 0.23); margin: auto; display: block; margin-bottom: 40px; transition: all .2s ease-out; border: 1px solid #1ebae2; position: relative; z-index: 2; overflow: hidden; top: 0px; opacity: 0; animation: position .5s ease-out 1; animation-fill-mode: forwards; animation-delay: 0.8s } .content-404 .btn-back-404:hover { box-shadow: 0 0px 0px rgba(0, 0, 0, 0.16), 0 0px 0px rgba(0, 0, 0, 0.23); z-index: 10; color: #38B4C6; } .content-404 .btn-back-404 span { font-size: 14px; font-weight: 600; color: #bef1ff; transition: all .2s ease-out; } .content-404 .btn-back-404:hover span { color: #0b99bd; } .content-404 p { color: #909090; position: relative; top: 0px; opacity: 0; animation: position .5s ease-out 1; animation-fill-mode: forwards; animation-delay: 1s } .btn-back-404::before { content: ''; position: absolute; z-index: -1; -webkit-transition: all .4s cubic-bezier(0.29, 0.76, 1, 1); transition: all .4s cubic-bezier(0.29, 0.76, 1, 1); width: 110%; height: 600%; top: 50%; left: 50%; background: #1ebae2; opacity: 1; -webkit-transform: translateX(-50%) translateY(-50%) rotate(-45deg); transform: translateX(-50%) translateY(-50%) rotate(-45deg); } .btn-back-404:hover::before { height: 0%; opacity: .1; } @keyframes fadein { from { opacity: 0; top: 53%; } to { opacity: 1; top: 50%; } } @keyframes position { from { opacity: 0; top: 10px; } to { opacity: 1; top: 0; } } @media screen and (max-width: 1680px) { .container-404 { background: url('https://online.bremss.org/images/manager/errors/ConferenceRoom1680_optimized.jpg'); background-repeat: no-repeat; background-size: cover; background-position: 0% 50%; } } @media screen and (max-width: 640px) { .content-404 { width: 380px; margin-left: -190px; margin-top: -180px; padding: 15px 10px } .content-404 h2 { margin: 20px 0; font-size: 20px; } .content-404 h3 { font-size: 16px; } .logo-idloom-404 img { width: 140px; } .content-404 .btn-back-404 { margin-bottom: 20px; } } @media screen and (max-width: 375px) { .content-404 { width: 300px; margin-left: -150px; } .container-404 { background-position: 20% 50%; } }

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