Forms & Protocols

 OSF East Central Illinois EMS System Entry

• Process and Contact Information 

• System Entry Application (PDF - 103.1 KB)

OSF East Central Illinois EMS

• System Forms

• EMS Risk Screen (PDF - 426.1 KB)

  EMR Medication Order Form (PDF - 202.2 KB)

  BLS Medication Order Form (PDF - 54.7 KB)

  ILS Non-Transport Medication Order Form (PDF - 299.5 KB)

  ALS Non-Transport Medication Request Form (PDF - 304.9 KB)

  ALS Transport Medication Order Form (PDF - 304.7 KB)

• Controlled Substance Forms

• ALS Controlled Substance Monthly Inventory Log (PDF - 508.6 KB)

  ILS Controlled Substance Monthly Inventory Log (PDF - 507.1 KB)

  Controlled Substance Daily Security Log (PDF - 577.5 KB)

  Controlled Substance Administration Log (PDF - 569.0 KB)

  Controlled Substance Risk Screen (PDF - 310.8 KB)

  Controlled Substance Risk Screen - Fillable PDF (PDF - 320.2 KB)

Policies

• East Central Illinois EMS System Policies

• East Central Illinois EMS System Policies (PDF - 4.7 MB)

Licensure

• Provider Licensure

• Fee Waiver Request (PDF - 99.3 KB)

  License Extension Request (PDF - 812.5 KB)

  Inactive Request (PDF - 274.0 KB)

  NREMT EMT Handbook (PDF - 281.3 KB)

  NREMT Paramedic Handbook (PDF - 381.1 KB)

  IDPH EMS CE Recommendations (PDF - 388.2 KB)

• Vehicle Licensure

• All Levels System Inspection/Minimum Equipment List (PDF - 737.8 KB)

  IDPH Aircraft Inspection (PDF - 155.5 KB)

  IDPH Ambulance Inspection (PDF - 845.7 KB)

  IDPH Non-Transport Inspection (PDF - 181.2 KB)

  ECIEMS EMR Minimum Equipment List

  ECIEMS BLS Minimum Equipment List

  ECIEMS ILS Non Transport Minimum Equipment List

  ECIEMS ALS Non Transport Minimum Equipment LIst

  ECIEMS ALS Transport Minimum Equipment List

Protocols

• East Central Illinois EMS Protocols

• ECIEMS Protocols Effective 5/1/2020 (PDF - 16.1 MB)

  Inter-facility Transfers (PDF - 240.2 KB)

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