Forms & Protocols

 OSF East Central Illinois EMS System Entry

• Process and Contact Information 

• System Entry Application (PDF - 224.1 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 - 141.8 KB)

  IDPH Non-Transport Inspection (PDF - 880.9 KB)

  If you need a level specific inspection form or minimum equipment list, please contact our office.

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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