About NJTA: Ambulance Reporting

First Aid Reporting Instructions

Important: This report must be completed in it's entirety and the original copy is to be submitted as soon as possible after responding to an ambulance call within the New Jersey Turnpike or Garden State Parkway right-of-way.

Please ensure that all report forms for the first half of the calendar are submitted no later than July 15th, and for the second half of the calendar year are submitted no later than January 5th.
FORMS SUBMITTED AFTER THE DEADLINE WILL NOT BE ACCEPTED.

Please note that all fields listed below are required for report to submit.

Ambulance Squad:
Address:

Phone:
Date of Call:
Time of Call:
Recall Before Arrival:

Arrived and No Service Required:		 Yes No
Yes No
Weather:
Point of Entry:
Point of Exit:
Location of Incident (Milepost, Interchange or Service Area):
Number of Injuries:
How Were Injuries Incurred:
Name of Hospital:
Time of Arrival:
Driver of Ambulance:
Breif Description of What Was Performed at the Scene:
Officer Making Report:
E-Mail Address:
Rank:
Submission Date:

» New Jersey Turnpike Authority Government Records Request