Applications & Forms

The following applications/forms pdfs have been removed from the Bureau of Emergency Medical Services website and are now located in the service agency portals. You must have the correct permissions for your agency to access the forms or applications. If you do not have access in your portal to these forms please contact the Bureau so that the correct permissions can be assigned to you.

Image Trend Online License Management System

Please allow 30 business days for processing.

• Communicable Disease Exposure Report
• Fingerprinting MSHP Form for Initial Licensure

Outside the Hospital Do-Not-Resuscitate Order

• Approved Medallion Vendor Contact Information
• Authorization Form (black/white) Authorization Form (purple)
• Definitions of Key Terms (black/white) Definitions of Key Terms (purple)
• Frequently Asked Questions
• Identification Card (black/white) Identification Card (purple)