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PAPER PCR PORTAL NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Emergency Medical Services and Trauma SystemsApplication and Approval for EMS Agency to Use ePCRBEFORE PURSUING ANY ECR SYSTEM, CONTACT
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01
Start by filling out the basic information section with your name, contact information, and agency name.
02
Provide details about the type of service requested, including date, time, and location of the event or incident.
03
Include information about any specific requirements or special accommodations needed for the request.
04
Fill out the transport information section with details about the patient or patients, including their names, ages, and medical conditions.
05
Complete any additional information sections as needed, such as insurance information or billing details.
06
Review the completed form for accuracy and completeness before submitting it to the EMS agency.

Who needs ems agency request for?

01
EMS agency request forms are typically needed by event organizers, healthcare facilities, nursing homes, and individuals who require emergency medical services for transportation or assistance during an event or medical emergency.
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The ems agency request is for requesting emergency medical services from a designated agency.
Any individual or organization in need of emergency medical services is required to file an ems agency request.
The ems agency request form must be completed with all relevant information about the emergency medical services needed.
The purpose of the ems agency request is to ensure that the appropriate emergency medical services are provided in a timely manner.
The ems agency request must include details about the nature of the emergency, location, and contact information for the requesting party.
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