IDPH Special Events Form

This form is a tool for special event EMS standby's

Pediatric Readiness Checklist

This form is a tool for agencies to assess their pediatric readiness.

EMS Short Form

This form is designed to be left at the receiving facility. This provides a short overview of patient care until your chart is completed.

School Bus Release Form

This form is the IDPH Region 2 school bus refusal release form.

IDPH Training Application

This form is for applying for a training course.

Agency Information Change Form

This form is used to update agency contact information for MCAEMS and IDPH

IDPH Request to Modify/Amend

This form is for modifying/amending approved system plans and vehicles.

Medication Replacement - BLS

Medication replacement for BLS units

Medication Replacement - ILS

Medication replacement for ILS units

Medication Replacement - ALS

Medication replacement for ALS units

Combined Supply List

This is a combined list of the state and system equipment requirements

IDPH Non-transport Inspection Form

This is the inspection form for non-transport agencies. It only covers the state minimums.