Notice of Privacy Practices

Notice of Privacy Practices available in HTML (web page) or PDF formats.


Forms

Physician Certification Statement (PCS)

This form is required for inter-facility ambulance transports. The forms requires physician or a representative to sign and state why the patient requires ambulance transport.

Wisconsin Patient Side Training Report

For TSA Paramedic use. Completion of this form designates that an ambulance service transported a medication that does not appear on the “Wisconsin Paramedic
Curriculum Based Medication List” or the services approved operational plan.


Protocols

Tri-State Ambulance medical direction offers an advanced set of pre-hospital protocols.

Download Protocols PDF