San Mateo County Seal San Mateo County
Health Department

EMS | Forms


These forms are used within the San Mateo County EMS system or may be used to communicate with the EMS Agency.

 

Forms for the Public Forms for System Providers
Public Access Defibrillator Registration Medication Restock
Do Not Resuscitate Refusal of Service
Emergency Information Form for Children with Special Needs Elder/dependent adult abuse
Expediente de Información de Emergencia para Niños con Necesidades Especiales Child abuse/neglect
  Intubation QI Form
  EMD PSC Field Feedback Form (online) 
  EMS System Issue Resolution Form (.doc)
  AMR Reach IT Access Registration Form
EMSystem Instructions

Hospital Status & MCI Polling

 

Trauma Center Status & MCI Polling

 

Hospital Daily Reports