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PUBLIC HEALTH DIVISION Emergency Medical Services and Trauma Systems EMS Provider Reportable Actions Please complete the applicable sections of this form and submit it to the Oregon Health Authority EMS and Trauma Systems Office. Signature Date Reference state or federal laws relating to confidentiality or the protection of health information that might prohibit an EMS Provider from reporting prohibited or unprofessional conduct. Name REPORT WITHIN 30 DAYS Last name EMR EMT First name...
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Find a copy of the emergency medical services form.
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Read through the form to understand the information needed.
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Gather all necessary personal information, such as name, address, date of birth, and contact details.
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Fill out the form accurately and truthfully, providing all required information.
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Pay attention to any specific instructions or additional information requested on the form.
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If applicable, provide details about the medical emergency or condition that requires medical services.
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Ensure that you sign and date the form.
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Submit the completed form to the relevant authority or organization responsible for emergency medical services.

Who needs emergency medical services and?

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Anyone who experiences a medical emergency requiring immediate attention can benefit from emergency medical services.
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Individuals with severe injuries, heart attacks, strokes, allergic reactions, or other life-threatening conditions should seek emergency medical services.
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Additionally, individuals who are unable to safely transport themselves to a medical facility due to their condition may require emergency medical services.
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Emergency medical services are also crucial for victims of accidents, violence, or sudden illness that require professional medical assistance on-site and during transportation to a hospital.
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It is important to remember that emergency medical services are not limited to a specific age group or medical condition; anyone in need of urgent medical care can access these services.
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Emergency medical services (EMS) refer to the system that provides medical care in emergencies, including pre-hospital care, ambulance services, and coordination with medical facilities.
Emergency medical services are typically filed by healthcare providers, EMS agencies, and hospitals that provide emergency medical care.
To fill out emergency medical services, providers need to report information about the patients treated, the services provided, and any transfers to other medical facilities.
The purpose of emergency medical services is to ensure that individuals in urgent need of medical care receive timely and appropriate treatment to improve health outcomes.
Information typically reported on emergency medical services includes patient demographics, treatment provided, medications administered, and outcomes of care.
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