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.

Guidelines/Protocols

Tri-State Ambulance medical direction offers an advanced set of pre-hospital guidelines. Download Guidelines PDF