{"id":9593,"date":"2025-03-01T13:59:05","date_gmt":"2025-03-01T18:59:05","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/forms\/"},"modified":"2025-07-11T13:23:00","modified_gmt":"2025-07-11T17:23:00","slug":"forms","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/ems\/forms\/","title":{"rendered":"ems\/forms ~  Forms about ems programs  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\r\n\r\n\r\n\r\n\r\n\r\n  <br>\r\n\r\n\r\n  \r\n\r\n\r\n  <div class=\"container\" id=\"main_header\">\r\n\r\n\r\n    <!-- BEGIN readspeaker div -->\r\n\r\n\r\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\r\n\r\n\r\n      <a class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&amp;lang=en_us&amp;readid=main_content&amp;url=https:\/\/dhss.delaware.gov\/dph\/ems\/forms.html\" title=\"Listen to this page using ReadSpeaker\">\r\n\r\n\r\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\r\n\r\n\r\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\r\n\r\n\r\n      <\/a>\r\n\r\n\r\n    <\/div>\r\n\r\n\r\n    <!-- END readspeaker div -->\r\n\r\n\r\n\r\n\r\n\r\n    \r\n\r\n\r\n    <header class=\"pull-left\">\r\n\r\n\r\n      <h1><!--[type=EDIT name=\"Page Title\"]-->Forms about EMS Programs<!--[END]--><\/h1>\r\n\r\n\r\n    <\/header>\r\n\r\n\r\n  <\/div><br>\r\n\r\n\r\n \r\n\r\n\r\n  <div class=\"container\">\r\n\r\n\r\n    <div class=\"row\">\r\n\r\n\r\n      <div class=\"col-md-3\" id=\"leftCol\">\r\n\r\n\r\n        <div class=\"panel-group\" id=\"accordion\">\r\n\r\n\r\n          <div class=\"panel sectionmenu_panel\">\r\n\r\n\r\n            <div class=\"panel-heading\">\r\n\r\n\r\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\r\n\r\n\r\n            <\/div>\r\n\r\n\r\n\r\n\r\n\r\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\r\n\r\n\r\n              <div class=\"panel-body\" id=\"clf_nav\">\r\n\r\n\r\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\r\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\r\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\r\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\r\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\r\n        <li><a href=\"\/dph\/sections.html\">Sections &amp; Programs<\/a><\/li>\r\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\r\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\r\n      \r\n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\r\n      <\/ul>\r\n    <\/li>\r\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\r\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\r\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\r\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &amp; Water Quality<\/a><\/li>\r\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &amp; Marriage Records<\/a><\/li>\r\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\r\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &amp; Statistics<\/a><\/li>\r\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\r\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &amp; Wellness<\/a><\/li>\r\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\r\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\r\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\r\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\r\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\r\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\r\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\r\n      <\/li><\/ul>\r\n    <\/li>\r\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\r\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\r\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\r\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &amp; Reports<\/a><\/li>\r\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &amp; Conditions<\/a><\/li>\r\n        <li><a href=\"\/dph\/faq.html\">FAQ&#8217;s<\/a><\/li>\r\n        <li><a href=\"\/dph\/php\/alerts.html\">Health Alerts<\/a><\/li>\r\n        <li><a href=\"\/dph\/healthylifestyles.html\">Healthy Lifestyles<\/a><\/li>\r\n        <li><a href=\"\/dph\/hipaa.html\">HIPAA<\/a><\/li>\r\n        <li><a href=\"\/dph\/regs.html\">Regulations<\/a><\/li>\r\n        <li><a href=\"\/dph\/forms.html\">Request Forms<\/a><\/li>\r\n        <li><a href=\"\/dph\/links.html\">Links &amp; Resources<\/a><\/li>\r\n        <li><a href=\"http:\/\/delaware.gov\/help\/foia_request.shtml\">FOIA Request Form<\/a><\/li>\r\n      <\/ul>\r\n    <\/li>\r\n\r\n\r\n\r\n              <\/div>\r\n\r\n\r\n            <\/div>\r\n\r\n\r\n          <\/div>\r\n\r\n\r\n        <\/div><br>\r\n\r\n\r\n      <\/div>\r\n\r\n\r\n\r\n\r\n\r\n      <div class=\"col-md-9\" id=\"main_content\"> \r\n\r\n\r\n  <!--[type=HTMLEDIT name=\"Content\"]-->\r\n\r\n\r\n\r\n\r\n\r\n<ul>\r\n\r\n\r\n\r\n\r\n <li><a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/aedform03.pdf\" title=\"AED Registration Form\">AED Registration Form PDF format<\/a><\/li>\r\n\r\n\r\n\r\n\r\n <li><a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/aedform02.pdf\" title=\"AED potential use form PDF format\">AED Potential Use Form PDF format<\/a><\/li>\r\n\r\n\r\n\r\n\r\n <li><a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/ContinuingEducationForm2023Fillable.pdf\" title=\"Continuing Education Credit Form\">Continuing Education Credit Form PDF format<\/a><\/li>\r\n\r\n\r\n\r\n\r\n <li><a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/CourseRequestFormFillable2023.pdf\" title=\"Course Information Form\">Course Information Form PDF format<\/a><\/li>\r\n\r\n\r\n\r\n\r\n <li><a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/ReportofPotentialExposureFormEMCP.pdf\" title=\"Prehospital Exposure Form Responders\">Prehospital Exposure Form PDF format<\/a><\/li>\r\n\r\n\r\n\r\n\r\n <li><a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/safekidsform.pdf\" title=\"Safe Kids Delaware form\">Safe Kids Delaware form PDF format<\/a><\/li>\r\n\r\n\r\n\r\n\r\n<\/ul>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>For more information, please contact the <a class=\"anchors_link\" href=\"\/dph\/contact.html#emergencymedicalservices\">program office<\/a>.<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p><a href=\"ems.html\">Return to Delaware EMS homepage<\/a><\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>\u00a0<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p><br>\r\n\r\n\r\n\r\n\r\n<\/p><p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader.  A free copy of Adobe Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>\u00a0<\/p>\r\n\r\n\r\n\r\n\r\n  <!--[END]-->\r\n\r\n\r\n  \r\n\r\n\r\n      <\/div>\r\n\r\n\r\n    <\/div>\r\n\r\n\r\n  <\/div><!-- \/container -->\r\n\r\n\r\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Forms about EMS Programs Public Health Menu Home About About DPH Sections &amp; Programs Office Locations Contact Info Calendar Services A-Z Services Air &amp; Water Quality Birth, Death, &amp; Marriage Records Clinics Health Data &amp; Statistics Emergency Preparedness Health &amp; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections Screening and Testing WIC Additional Services [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9579,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-9593","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9593","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=9593"}],"version-history":[{"count":2,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9593\/revisions"}],"predecessor-version":[{"id":12521,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9593\/revisions\/12521"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9579"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=9593"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}