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Agency Medical Director Credentialing Packet

Agency Medical Director Letter of Agreement

Agency Medical Director Information Form (every agency must submit this form annually by January 31)

Agency Medical Director Verification Form (DOH-4362)

Agency Personnel Roster Form

ALS Provider, Agency Letter of Support Form

AED BLS Application

Awards Application

Awards Criteria

Credentialing Application

BLS 12-Lead ECG - Call REMSCo office for training packet and forms

BLS Albuterol Request Form

BLS CPAP - Call REMSCo office for training packet and forms - must be taught by CC or P CIC

BLS Epinephrine Syringe Program

EMS Agency Directory Survey Form

EMS Agency Information Update Form

EMS Agency Quarterly QI Report Form

Epi-Pen Program for EMS Providers

Epi-Pen Program for School and Camps

Hospital Directory Survey Form

Intranasal Naloxone Information

Narcotics Information and Application Forms (Link to most up-to-date forms)

Public Access Defibrillation Program (PAD)

 

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