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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.

Advanced Life Support | Annual Awards |
Automated External Defibrillators  | Licensing |  
Preparedness Topics | Research and Quality Improvement | 
Training, Education and Practical Exams  | Trauma System
 

Advanced Life Support

2007 Patient Care Protocols Version 3
Version 3 Protocol Changes Update
Current Approved Medication List (3/27/07)
Sample Protocol Exam
Paramedic Re-entry

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Annual Awards

The following Emergency Medical Services Awards are made annually. For information and nomination directions click on the award title. The 2007 New Hampshire EMS Awards Nominations are now closed. The 2008 Annual EMS Awards Nominations are now being accepted – please see the 2008 Nomination Form for details .

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)

2002 AED Grant Placement Locations
2002 AED Placement Map
2003 AED Grant Placement Locations
2003-2005 Rural AED Placement Map
AED Fact Sheet - Region 1
AED Fact Sheet - Region 2
AED Fact Sheet - Region 3
AED Fact Sheet - Region 4
AED Fact Sheet - Region 5
AED Incident Report Form
AED Registry Forms
AED Request Form
HeartSafe Communities
Public Access Defibrillation in New Hampshire Schools

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Licensing

EMS Instructor/Coordinator License Renewal Application
EMS Instructor License Application
EMS Provider License Application
EMS Vehicle License Application
Equipment/Inspection Sheets
Licensing Laws and Rules
Non-transporting EMS Unit License Application
Transporting EMS Unit License Application

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Preparedness Topics

Avian Flu Fact Sheet
Avian Influenza and Pandemic Flu Frequently Asked Questions
EMS Mitigation and Planning Resources
EMS Response and Recovery Resources
Hospital Driving Directions
Meningitis Fact Sheet
Mutual Aid Assessment
National Incident Management System (NIMS) Training Synopsis
Recommendations for EMS Providers Regarding Meningococcal Meningitis
Sample EMS Unit Mutual Aid Agreement
USFA Fire and Emergency Services Preparedness Guide for the Homeland Security Advisory System

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Research and Quality Improvement

Sample Drop Off and Refusal Forms - Provided by Pam Drewniak, District C-5 and Dick Cooper, Portsmouth Regional Hospital. The Division of Fire Standards and Training & Emergency Medical Services neither endorses nor recommends these forms but provides them as a sample for your use.
TEMSIS Data Dictionary
TEMSIS Implementation Plan
TEMSIS A System Overview and Helpful Tips for TEMSIS Users
Internet Best Practices Expert
TEMSIS Security Internet Explorer
TEMSIS Security Mozilla Firefox

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Training, Education and Practical Exams

ALS Training Equipment Request Form
Authority to Establish Courses
BLS Practical Examination Evaluator Application - Initial
BLS Practical Examination Evaluator Application - Renewal
Clinical / Field Internship Affiliation Form
Course Completion Roster
Course Completion Roster Addendum
Course/Module Request Form
Emergency Medical Technician - Basic (Practical Exam Sheets)
EMT-I National Registry Re-Registration Procedure
First Responder (Practical Exam Sheets)
NHFA General Admissions Application Form
Region III Practical Exam Form
Request for Examination
Request for Duplicate Certification
Synopsis of Bureau Approved Training Programs

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Trauma System

Interactive Materials Available for Loan
NH Trauma System Map

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