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Background: Older adults commonly call 911 because of a ground-level fall and many of these patients are not transported to hospital. Paramedic fall referral to community-based fall prevention teams can mitigate adverse events for those not transported. Our objective was to describe the paramedic referral rate and barriers to the referral process in a provincial emergency medical services (EMS) system. This study is supported by the Trauma Association of Canada Lerners Grant awarded in March 2020. Methods: We will use mixed methods including a retrospective analysis of patients with a ground-level fall and nontransport outcome, and interviews with paramedics. All patients with a fall-related complaint or paramedic-identified fall risk, with nontransport disposition and referral between Feb. 1, 2014, and Feb. 1, 2020, will be included. We will conduct a semistructured interview with paramedics to understand barriers to offering referral. Results: In Nova Scotia, patients who present to paramedics with a fall-related complaint and nontransport disposition can be referred to a fall prevention program in some parts of the province. Previous studies suggest 50% of patients who have fallen will have a relapse call (another 911 call) within 30 days. Paramedic fall referral programs may mitigate this risk. In this study, we will describe the implementation of the program and barriers to referral to develop recommendations to optimize its use. We will determine whether a fall referral leads to a reduction in fall-related EMS use within 12 months of the original call and evaluate factors that may impede fall referral by comparing the characteristics of those offered referral with the characteristics of those who were not. Conclusion: Canadas population is aging. This means that aging-related complaints will become more common. Paramedics can play a proactive role in identifying and referring older adults at risk for age-related health care problems such as falls. Identifying a patient at risk for a fall earlier and intervening may prevent future injurious falls.