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The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county & community efforts.

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EMS Forms and Documents

Contact the Florida Department of Health

  •  850-245-4440
  •  
  •  

    Fax

    850-245-4378
  •  

    Mailing Address

    Florida Department of Health 

    4052 Bald Cypress Way Bin A-22 

    Tallahassee, FL 32399 

  • Education Forms
  • EMS Service Provider Licensing Forms
  • EMS for Children Forms
  • EMS Grants Forms
  • EMS Inspections Forms
  • Miscellaneous Forms & Documents

Continuing Education application - Editable Version - DH form 1698C

Application for Approval of an EMS Training Program - Editable Version - DH Form 1698, 12/08

CPR/ACLS equivalent application - Editable Version DH Form 1938, February 2/02

Ground Ambulance Service Provider Licensure Application DOH Form 631

 Air Ambulance Service Provider Licensure Application - DOH Form 1575

 Application for Vehicle Permit(s) DOH Form 1510

Application for Air Ambulance Permit DOH Form 1576, April 2009

Student Injury Report Form

Interfacility Transfer Guidelines Toolkit and Form Template

EMS County Grant Application

Inspection Corrective Action Form

Inspection Narrative Form

Air Ambulance Inspection Report Form

Neonatal Interfacility Vehicle Inspection Form

Equipment Test Results

ALS Vehicle Inspection Form

BLS Vehicle Inspection Form

Service Records and Facilities Inspection Form

Personnel Records

Public Records Exemption

Stroke Assessment Tool

EMS Course Completion Roster

AHCA Stroke Center List

Comprehensive Stroke Center with 45 Minute Drive Time Analysis

DH Form 1256

Do Not Resuscitate Form 1896 (Per rule 64J-02.018, this form shall be printed on yellow paper.)

EMS State Awards Application

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