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Bureau of Emergency Medical Services
Documents & Forms

All documents and forms have been saved in Adobe Acrobat Reader Adobe Acrobat Reader Symbol format unless otherwise noted.

Advanced Life Support | Annual Awards |
Automated External Defibrillators | EMS Best Practices |
Licensing | Preparedness Topics | Research and Quality Management/TEMSIS |
Training, Education and Practical Exams | Trauma System

Advanced Life Support

2013 Patient Care Protocols
2013 NH Approved Medication List for EMS Providers
Paramedic Re-entry
Preplanned Medical Standby Coverage Plan
Clinical Practice Inquiry Form

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Annual Awards

Nominations for the six 2015 EMS Annual Awards are now open! Please submit the completed Nomination Form to the address on the document. The nominations must be postmarked by June 1, 2015 in order to be considered. For questions regarding the awards process, please contact Kathy Doolan, EMS Field Services Coordinator.

The 2015 Fire and EMS Committee of Merit Awards ceremony will be held in the fall at the Concord City Auditorium. Please contact us for further information.

Bound Tree Corporation EMS Unit of the Year Award
David F. Dow Memorial EMS Provider of the Year Award
David J. Connor Memorial EMS Appreciation Award - "The Connor Honor"
EMS Educator of the Year Award
Pamela Mitchell/Richard Connolly Memorial EMS Achievement Award
Lawrence A. Volz EMS Heroism Award

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Automated External Defibrillators (AED)

AED Registry Form
AED Vendor Listings
Frequently Asked Questions
HeartSafe Communities
Public Access Defibrillation in New Hampshire Schools
Resource for AED Materials

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EMS Best Practices
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Brochure: Licensing Laws and Rules
Change of Providers Unit Affiliation Application
EMS Instructor/Coordinator License Initial Application
EMS Instructor/Coordinator License Renewal Application
EMS Provider License Application (downloadable pdf version)
EMS Provider License -Renewal- Application (online application - must have LIN#)
EMS License Waiver Requirements
EMS Unit License Application
EMS Vehicle License Application
Law Enforcement Provider License Information
Ambulance Equipment/Inspection Sheets
-Wheelchair Van-For-Hire Company Application
-Wheelchair Van-For-Hire Van Application
-Wheelchair Van-For-Hire Van Inspection Sheet
Protocol Exam Instructions 2013
SAMPLE Apprentice Provider Affiliation Forms

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Preparedness Topics

Avian Influenza (Bird Flu) Facts
EMS Mitigation and Planning Resources
EMS Response and Recovery Resources
Guide to Infection Prevention in EMS
Hospital Driving Directions
Meningitis Fact Sheet
Mutual Aid Assessment
NH Influenza Pandemic Health Preparedness & Response Plan
NH Public Health Emergency Preparedness & Response Plan
National Incident Management System (NIMS) Training Synopsis
Sample EMS Unit Mutual Aid Agreement
Swine Influenza (H1N1) Facts
USFA Fire and Emergency Services Preparedness Guide for the Homeland Security Advisory System

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Research & Quality Management / TEMSIS

Improving Basic Cardiac Care in NH EMS - Aspirin Administration in 2014
Basic Cardiac Care in NH Follow-Up
Basic Stroke Care in NH

TEMSIS Users Manual
TEMSIS - How to Use the Incident List

TEMSIS Report Writer-Basic Transitional Report Guide

TEMSIS - Procedures List Change Memo
TEMSIS - Procedures Changes Reference List Old to New
TEMSIS - Procedures Changes Reference List New to Old
TEMSIS - Procedures Changes Refrence List Details and 3rd Party Vendors

TEMSIS - Adding Zones or Districts to your Service to Display and Collect on the EMS Incident Report
TEMSIS - Town Names will be Updated Effective April 15th, 2015
TEMSIS - Town Name Before and After April 15th, 2015 Comparison

TEMSIS (V2.2.1) Required NEMSIS Elements and Values These are all the elements and values required and/or allowed to be submitted by third party software into the TEMSIS system.
TEMSIS (V2.2.1) ALL Elements and Values Collected Includes all required and optional NEMSIS elements and values and custom elements only available to users who directly enter into TEMSIS.

NEMSIS Data Dictionary Version 2.2.1
NEMSIS Version 2.2.1 Extended Data Definitions

TEMSIS Comparison of Field Bridge Options
Field Bridge Express License Request and Agreement
Field Bridge License Request and Agreement
How to Set Up Field Bridge Express

Internet Best Practices Expert
TEMSIS Security Internet Explorer
TEMSIS Security Mozilla Firefox

NH Statewide Comprehensive EMS Survey

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Training, Education and Practical Exams

ALS Exam Registration (online application)
ALS Training Equipment Request Form
Authority to Establish Courses
BLS Equipment Request
BLS Practical Examination Evaluator Application - Initial
BLS Practical Examination Evaluator Application - Renewal
Clinical/Field Internship Affiliation Form
Course Completion Roster
Course Completion Roster Addendum
Emergency Medical Technician (EMT) Practical Exam Sheets
EMS Course Request - (online application)
EMS Reciprocity Information
Emergency Medical Responder (EMR) Practical Exam Sheets
I/C Resource: Guide for Borrowing BLS and ALS Equipment
I/C Resource: Skills Assessment-Personnel/Equipment
Medical Professional Challenge: First Responder
Medical Professional Challenge: Basic
Medical Professional Challenge: AEMT
Medical Professional Challenge: Paramedic
NHFA General Admissions Application Form
Practical Examination Coduct & Removal
Practical Examination Dress Code
Request for Examination (BLS)
Request for Duplicate Certification
Synopsis of Bureau Approved Training Programs

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Trauma System

Trauma Hospital Assignment Application
Trauma Hospital Application Worksheet Microsoft Excel Symbol
Trauma System FAQ's
Current NH Trauma System Plan
NH Guidelines for the Imaging of the Trauma Patient
NH Trauma System Map
NH Trauma System Map - Pediatric
Welcome to the Trauma Medical Review Committee

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