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Bureau of Emergency Medical Services
Documents & Forms

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

Advanced Life Support

Preplanned Medical Standby Coverage Plan Adobe Acrobat Reader Symbol
Clinical Practice Inquiry Form Adobe Acrobat Reader Symbol
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Annual Awards

The Annual EMS Awards nominations are "opened" for submission at all times. Consideration of the nominations is made by the EMS Awards Committee within two months following the July 1st deadline. The Awards ceremony takes place in conjunction with the Fire Service Committee of Merit Awards, held in September of each year. Please contact Kathy Doolan, Captain, EMS Operations for additional details.
Throughout the year, as you wish to recognize an agency or individual during future award events, there is an "EMS Accolades Report" submission form that can be used to "bookmark" the recognition for the next year's award event. The Divisions' Resource Center address is: https://nhfa-ems.com/ems-resources/ems-accolades-report/ . An email will be sent to our staff and we will be in touch with more details.

NH Annual EMS Awards: Nomination Form Adobe Acrobat Reader Symbol

Bound Tree Corporation EMS Unit of the Year Award Adobe Acrobat Reader Symbol
David F. Dow Memorial EMS Provider of the Year Award Adobe Acrobat Reader Symbol
David J. Connor Memorial EMS Appreciation Award - "The Connor Honor" Adobe Acrobat Reader Symbol
EMS Educator of the Year Award Adobe Acrobat Reader Symbol
EMS Lifetime Achievement Award Adobe Acrobat Reader Symbol
Pamela Mitchell/Richard Connolly Memorial EMS Achievement Award Adobe Acrobat Reader Symbol
Lawrence A. Volz EMS Heroism Award Adobe Acrobat Reader Symbol
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Automated External Defibrillators (AED)

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

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EMS Best Practices
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Licensing

Brochure: Licensing Laws and Rules Adobe Acrobat Reader Symbol
Criminal History Record Information (CHRI) Authorization Form Adobe Acrobat Reader Symbol
EMS Instructor/Coordinator License Initial & Renewal Application Adobe Acrobat Reader Symbol
New or Lapsed EMS Provider License Application Adobe Acrobat Reader Symbol
EMS Provider License -Renewal/Upgrade Applicationrenewal application (online application - must have LIN#)
EMS Provider License Renewal/Upgrade/Change of Unit Adobe Acrobat Reader Symbol
EMS License Waiver Requirements Adobe Acrobat Reader Symbol
EMS Unit Training Officers: Scope of Practice Skills SheetSOP Skill Sheets(for skill verification)
EMS Unit License Application Adobe Acrobat Reader Symbol
EMS Vehicle License Application Adobe Acrobat Reader Symbol
Law Enforcement Provider License Information Adobe Acrobat Reader Symbol
Ambulance Equipment/Inspection Sheets Adobe Acrobat Reader Symbol- FORM UNDER REVIEW
-Wheelchair Van-For-Hire Company Application Adobe Acrobat Reader Symbol
-Wheelchair Van-For-Hire Van Application Adobe Acrobat Reader Symbol
-Wheelchair Van-For-Hire Van Inspection Sheet Adobe Acrobat Reader Symbol
SAMPLE Apprentice Provider Affiliation Forms Adobe Acrobat Reader Symbol
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Preparedness Topics

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

American College of Surgeons Trauma System Consultation Findings Letter (2016)Adobe Acrobat Reader Symbol
American College of Surgeons Trauma System Consultation Report - Final (2016)Adobe Acrobat Reader Symbol
Strategic Outreach ReportAdobe Acrobat Reader Symbol(2017)
State of New Hampshire NHTSA Reassessment Report - Executive Summary (2018)Adobe Acrobat Reader Symbol
State of New Hampshire NHTSA Reassessment Report - Final (2018)Adobe Acrobat Reader Symbol

TEMSIS / Emergency Services Data Management

NH EMS Data Dictionary V3.4.2.2Adobe Acrobat Reader Symbol - Updated September 16, 2019

TEMSIS/ Elite Training Videos for Providers and Service Leaders Adobe Acrobat Reader Symbol
TEMSIS Elite Service Leader vs. Provider Sessions Adobe Acrobat Reader Symbol
TEMSIS Elite Service Leader Setup Guide Adobe Acrobat Reader Symbol
TEMSIS Elite Transition Training Practice Scenarios Adobe Acrobat Reader Symbol

TEMSIS Transfer Feature Overview Adobe Acrobat Reader Symbol
Elite Browser Caching-Microsoft Adobe Acrobat Reader Symbol
Elite Browser Caching-Safari Adobe Acrobat Reader Symbol

TEMSIS Monthly Stakeholder Meeting Recordings:
(You can copy the link and past it into your internet browser address bar)

December 2017 Link: https://recordings.join.me/x8-waWINyE6Tpzq-xQx4Bg
January 2018 Link: https://recordings.join.me/ZkIc0SF7_EWDKaQj_WexmA
February 2018 Link: https://recordings.join.me/zUr88WePo0uPCRACDMdNng
March 2018 Link: https://recordings.join.me/juoTrrM-zEu7aYeedZulJQ
April 2018 Link: https://recordings.join.me/F9rukaMFgkivguF33P2vUQ
May 2018: No Meeting
June 2018: No Meeting
July 2018 Link: https://recordings.join.me/_S3gcuOgHEu0iOhsYAQmHg
August 2018 Link: https://recordings.join.me/b4am2qPRe0KpaCs5UAJ0wA
September 2018: No Meeting
October 2018: No Meeting
November 2018: No Meeting
December 2018 Link: https://recordings.join.me/Px-oGdpD0E2eve93reRZuw
January 2019 Link: https://recordings.join.me/C4DqUSHXNUWd0a5g1OeFHQ
February 2019: No Meeting
March 2019: No Meeting
April 2019: No Meeting
May 2019 Link: https://recordings.join.me/jy-CrlOiGEGE0HfdnjMbIA (Covers the addition of NFIRS Reporting)
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Training, Education and Practical Exams

BLS Practical Examination Evaluator Application - Initial Adobe Acrobat Reader Symbol
BLS Practical Examination Evaluator Application - Renewal Adobe Acrobat Reader Symbol
Clinical/Field Internship Affiliation Form Adobe Acrobat Reader Symbol
Course Completion Roster Adobe Acrobat Reader Symbol
Course Completion Roster Addendum Adobe Acrobat Reader Symbol
Emergency Medical Technician (EMT) Practical Exam Sheets Adobe Acrobat Reader Symbol - Updated 12/2015 (Without Spinal Immobilization)
EMS Course Request - (online application)
EMS Reciprocity Information - Under Review
Emergency Medical Responder (EMR) Practical Exam Sheets Adobe Acrobat Reader Symbol
I/C Resource: Skills Assessment-Personnel/Equipment Adobe Acrobat Reader Symbol
Intranasal Naloxone Administration Skill Sheet
EMT Challenge for Medical Professional - Information Sheet Adobe Acrobat Reader Symbol
Memo for Out-of-State Educational Programs Adobe Acrobat Reader Symbol
NHFA General Admissions Application Form Adobe Acrobat Reader Symbol
Practical Exam Candidate Instructions Adobe Acrobat Reader Symbol
Practical Examination Conduct & Removal - Under Review
Practical Examination Dress Code - Under Review
Request for Examination (BLS)
Request for Duplicate Certification Adobe Acrobat Reader Symbol
2018 Scope of Practice Skill Sheets Adobe Acrobat Reader Symbol
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Trauma System

State Adult & Pediatric Trauma Center Application & PRQ Adobe Acrobat Reader Symbol- Updated 7/2019
ACS Adult-State Pediatric Trauma Center Application & PRQAdobe Acrobat Reader Symbol
New Hampshire Trauma Center Criteria ChecklistAdobe Acrobat Reader Symbol
Trauma Medical Review Committee Newsletter - Winter 2016Adobe Acrobat Reader Symbol
Trauma System FAQ's
Current NH Trauma System Plan Adobe Acrobat Reader Symbol- Upated 9/2019
NH Guidelines for the Imaging of the Trauma Patient Adobe Acrobat Reader Symbol
NH Trauma System MapAdobe Acrobat Reader Symbol - Updated 5/2019
NH Trauma System Map - PediatricAdobe Acrobat Reader Symbol - Updated 5/2019
Welcome to the Trauma Medical Review Committee Adobe Acrobat Reader Symbol
2018 New Hampshire Trauma Registry Data DictionaryAdobe Acrobat Reader Symbol
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Adobe Acrobat Reader Symbol Adobe Acrobat Reader format. You can download a free reader from Adobe.
   
 
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