Forms and Publications

Protocols & Med Control Plan
BLS Protocols & Adjuncts
Agency Forms
 2017 Collaborative Protocols   NYS BLS Protocols   Agency Information Update Form
  Credentialing Policy  BLS Glucometry Application Packet  Agency Affiliation Revocation Form
  BLS IN Narcan Application Packet  ALS Provider Update Form
 Provider Retest Verification Form   BLS Albuterol Application Packet  Credentialing Renewal Application
 HVREMSCO Medical Control Plan   Albuterol Use Card  Agency Affiliation Form
  Med Control Shadow Plan   Epi Pen Application Packet -BLS
 Medical Procedures  Epi Pen Application Packet – Camps
Epi Pen Administration Form
BLS 12-Lead Acquisition
 Med Control Forms
 Agency Medical Director Air Medical Services Utilization Guidelines   Advanced Airway Placement Verification Form
 Physician MAC Application AMS Incident Report   Drug Shortage Use Form
  Physician Release Form
  Extreme Weather Operations
MC/PC Forms
Vecuronium Shortage CME Attendance Form Electronic PCR Memorandum of Understanding
Epi 1:10,000 Shortage   Med Control/Physician Contact Hours Verification Form  Electronic PCR Policy
Blood Draws for Law Enforcement  Med Control/Physician Contact Request Form
Pediatric Trauma Transport

New 11/2016

Planning Med Control Presentations
RSI Overview  Ebola REMAC Advisory  2017 Awards
Program Participation Agreement  NYS DOH Ebola Info – 8 December 2014
RSI Instructor Audit Form NYS DOH Ebola Info 10 September 2015
RSI Credentials Request Form


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