Welcome to the DC Health EMS Program Forms page. Here, you will find a comprehensive collection of forms and documents related to the EMS program in Washington, DC These forms are designed to assist healthcare professionals, emergency medical technicians, and other personnel in their daily responsibilities, ensuring the provision of high-quality care to the residents of the district. Feel free to browse through the various categories and download the forms

Continuing Education Curriculum Submission

• Form: EMS Lesson Plan Submission Template
• Form: EMS Course Submission Form

Practical Examination Forms for EMR Certification Testing

• Form: EMR Airway & Resuscitation Testing Skillsheet
• Form: EMR Medical Assessment Testing Skillsheet
• Form: EMR Trauma Assessment Testing Skillsheet
• Form: EMR IOHS Testing Skillsheet
• Form: EMR Skill Failure Form
• Form: EMR Exam Results Reporting Form
• Form: EMR Psychomotor Exam Grievance Form

Course Closure Documents - EMR

• Form: EMR Student Skill Verification Form
• Form: EMR Student Academic Validation Form
• Form: EMR Clinical Validation Form
• Form: EMR Student Final Disposition

Practical Examination Forms for EMT Certification Testing

• Form: EMT Airway & Resuscitation Testing Skillsheet
• Form: EMT Medical Assessment Testing Skillsheet
• Form: EMT Trauma Assessment Testing Skillsheet
• Form: EMT IOHS Testing Skillsheet
• Form: EMT Skill Failure Form
• Form: EMT Exam Results Reporting Form
• Form: EMT Psychomotor Exam Grievance Form

Course Closure Documents - EMT

• Form: EMT Student Skill Verification Form
• Form: EMT Student Academic Validation Form
• Form: EMT Clinical Validation Form
• Form: EMT Student Final Disposition

Mandatory Equipment List

• Form: Medical Aid Station Equipment Form
• Form: Ground Ambulance Inspection Form
• Form: Response Vehicle Inspection Form
• Form: Air Ambulance Inspection Form