iew privacy notification, file viewing information, and zip file download instructions.
Texas Department of State Health Services Regulatory Philosophy: The purpose of this philosophical statement of the Texas Department of State Health Services is to give guidance to the regulatory programs within the department on the ideal manner of conducting state business
EMS CERTIFICATION/LICENSURE FORMS
| Initial applications |
EMS personnel: ECA, EMT-basic, EMT-I, EMT-P or LP
|
PDF |
Read procedure |
| FAST Pass- Fingerprint form |
PDF |
Fingerprinting FAQs |
| Inactive certification/licensure |
PDF |
Read procedure |
| Out-of-state reciprocity |
PDF |
Read procedure |
Link to Regulatory Services Online Licensing System **UPGRADE ALERT**
IF YOU HOLD AN EMS CERTIFICATION AND WANT TO UPGRADE FOR CERTIFICATION AT A HIGHER LEVEL, YOU MUST SUBMIT THE INITIAL PAPER APPLICATION. UPGRADES IN CERTIFICATION CANNOT BE SUBMITTED ELECTRONICALLY AT THIS TIME. TO ACCESS THE PAPER INITIAL EMS CERTIFICATION APPLICATION.
|
Supplemental Forms
|
| ECA High School/GED Exemption- for candidates who meet volunteer criteria |
PDF |
| Address/Name change |
PDF |
| Rule Exemption- Request exemption from EMS rules |
PDF |
| Volunteer Sign-off form |
PDF |
| Wallet card replacement |
PDF |
EMS RECERTIFICATION/RELICENSURE FORMS
| Renewal Applications |
EMS personnel: ECA, EMT-basic, EMT-I, EMT-P or LP
|
PDF |
Read procedure |
| Inactive EMS certification/licensure |
PDF |
Read procedure |
| Volunteer-to-Paid Status Change- No longer exclusively a volunteer, you must pay cert fee |
PDF |
Link to Regulatory Services Online Licensing System
|
Supplemental Forms and Documents
|
| Downgrade Statement form- Apply for lower level of certification |
PDF |
| Skills Proficiency Form for Late Renewal |
PDF |
| Recertification options presention |
PowerPoint |
PDF |
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EMS COORDINATOR/INSTRUCTOR/EDUCATION PROGRAM FORMS
| Initial and Renewal Applications |
| Initial coordinator, instructor and information operator instructor |
PDF |
Process |
| Renewal coordinator, instructor and information operator instructor |
PDF |
Process |
| Educator Fee Exemption |
PDF |
| Education Program Applications |
EMS Education Program Application (Initial and Renewal)
|
Word
|
PDF
|
| Continuing Education Program Application - Initial and Renewal |
PDF |
Request to offer a DSHS approved National Registry of EMT Transition Course(s)
|
Word |
PDF |
| EMS Education Manual and Skill sheets |
| EMS Education and Training Manual (for coordinators)- Zipped file |
Word format |
Skills Criteria and Score Sheets- Basic Levels-
This document is not copyrighted- Zipped file |
Word format |
Skills Criteria and Score Sheets -Advanced Levels-
This document is not copyrighted- Zipped file |
Word format |
| National Standard Curricula |
| Emergency Medical Technician - Basic |
Word |
PDF |
| First Responder |
Word |
PDF |
Current release of National Standard Curriculum all levels
|
| Supplemental Forms and Resource Documents |
| Retest Application |
PDF |
Disability Accommodation Request-If you are taking the National Registry (NR) exam,
you must make an accommodation request to the NR office: www.nremt.org |
PDF |
| Course Completion Roster for ECA or EMT candidates (For students who are not yet 18 years of age) |
Word |
PDF |
| EMS Course Notification |
Word |
PDF |
| Functional Position Description |
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INJURY PREVENTION
| Documents and Presentations |
| Overview of Injury in Texas and the Role of the EMS/Trauma Registry Report |
PDF |
| Injury Prevention Curriculum |
Word format (zipped) |
| The GETAC Texas Injury Prevention Plan |
PDF |
| GETAC Injury Prevention Committee - Project Starfish |
Word |
PDF |
Triage Presentation- (8,409 KB) Please be aware that this file is very large
and may take several minutes to an hour to complete downloading.
|
PowerPoint |
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REGIONAL ADVISORY COUNCIL DEVELOPMENT
| Documents |
| Rule Interpretation: Regional Trauma Treatment Protocols as a component of the EMS/Trauma System Plan |
PDF |
| Texas Trauma System Power Point Presentation |
Self-extracting zip file |
| EMS/Trauma System Plan: A Supplement to the Texas Trauma System Manual |
PDF |
| Regional needs assessment (HOTRAC) |
PDF |
| Facility Resource Capability Form (Coastal Bend RAC) (external site) |
| Systems Quality Concern Form (Coastal Bend RAC) (external site) |
| Affidavit Acknowledging Utilization of RAC Regional Protocols Regarding Patient Destination and Transport |
PDF |
EMS and Trauma Care System Account and Emergency Medical Services, Trauma Facilities, and Trauma Care System Fund &
Designated Trauma Facility and Emergency Medical Services Account Documents
|
| EMS/Trauma Care System Account- report to the 77th Legislature (2001 |
PDF |
| EMS/RAC Expenditure Report Form |
(PDF) (Word)
|
| EMS/County Expenditure Report Form |
(PDF) (Word) |
| Tobacco Expenditure Report Form |
PDF |
STROKE FACILITY DESIGNATION
| COMPREHENSIVE (LEVEL I) AND PRIMARY (LEVEL II) FORMS |
| Complete Application for Comprehensive (Level I) and Primary (Level II) Designation |
PDF |
Word |
RESOURCE DOCUMENTS
|
Policy and Procedure: Facility with Conditional Certification as Primary Stroke Center and
De-Certification with The Joint Commission |
PDF |
| Guidance for Change of Legal Owner of a Hospital Facility (CHOW) and/or Change in Physical Location of a Hospital Facility and/or Impact to Stroke Facility Designation |
PDF |
TRAUMA FACILITY DESIGNATION
| COMPREHENSIVE (LEVEL I) & MAJOR (LEVEL II) |
| Complete Trauma Facility Designation Application |
PDF |
Word |
RESOURCE DOCUMENTS
|
Guidance for Change of Legal Owner of a Hospital Facility (CHOW) and/or Change in Physical Location of a Hospital Facility and/or Impact to Trauma Facility Designation
|
PDF |
| ADVANCED (LEVEL III) |
| Complete Application for Level III Designation |
PDF |
Word |
| Process for Level III Trauma Facility Designation Application |
PDF |
| Guidance on Essential Criteria for Level III Trauma Facility Designation |
PDF |
| Criteria Checklist for Level III Trauma Facility Designation |
PDF |
| Audit Filters for Level III Trauma Facility Designation |
PDF |
| Standards of Care for Level III Trauma Facility Designation |
PDF |
RESOURCE DOCUMENTS
|
| Requirements for Trauma Facility Designation Surveyors |
PDF |
| Trauma Designation Survey Process |
PDF |
| Initial/Re-designation Level III Agenda Format |
PDF |
| Trauma Designation Upgrade |
PDF |
| Policy – Late Applications |
PDF |
| Frequently Asked Question Regarding Trauma |
PDF |
Guidance for Change of Legal Owner of a Hospital Facility (CHOW) and/or Change in Physical Location of a Hospital Facility and/or Impact to Trauma Facility Designation
|
PDF |
| BASIC (LEVEL IV) TRAUMA FACILITY DESIGNATION |
| Complete Application for Level IV Designation |
PDF |
Word |
| Process for Level IV Trauma Facility Designation Application |
PDF |
| Guidance on Essential Criteria for Level IV Trauma Facility Designation |
PDF |
| Criteria Checklist for Level IV Trauma Facility Designation |
PDF |
| Audit Filters for Level IV Trauma Facility Designation |
PDF |
| Standards of Care for Level IV Trauma Facility Designation |
PDF |
RESOURCE DOCUMENTS
|
| Requirements for Trauma Facility Designation Surveyors |
PDF |
| Trauma Designation Survey Process |
PDF |
| Initial/Re-designation Level IV Agenda Format |
PDF |
| Trauma Designation Upgrade |
PDF |
| Frequently Asked Question Regarding Trauma |
PDF |
| Policy – Late Applications |
PDF |
Guidance for Change of Legal Owner of a Hospital Facility (CHOW) and/or Change in Physical Location of a Hospital Facility and/or Impact to Trauma Facility Designation
|
PDF |
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Once the files have been uncompressed, these document files will be in one of the following formats.
.pdf (personal document file) which is viewable with the Adobe Acrobat Reader
.dbf (database) which will import into most database programs
.txt (delimited text) which will import into most spread sheet programs
.wpd (WordPerfect document) which is viewable with Wordperfect 6.1 or later or Word 97 or later
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