Southern Tier Health Care System, Inc.
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Applications and Forms

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Agency Information Update Form
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ALS Narcotics Forms
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Blood Glucometry
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BLS 12 Lead
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Cattaraugus Co. CME Participant Tracking Form
​Check & Inject (Syringe Epinephrine)
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CPAP
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Ebola Preparedness Plan Sample Policy
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ePCR Application
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Epinephrine Auto-Injector Application
​Level of Care Change
​Medical Director Verification Form
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Medical Director Change Form
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MIST Report
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Narcan Administration
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Nebulized Albuterol
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Notice of AED use by PAD
​PCR Coversheet
PECC Application
​Preceptor Application
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Prehospital Drop Sheet - excel
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Prehospital Drop Sheet - pdf
Provider Privileges Application & Skills Evaluation Forms ​
​Voucher for Vital Signs
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Tax Credit Form for Volunteer Fire Fighters and Ambulance Workers
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800.21 General Requirements Checklist

Southern Tier Health Care System, Inc.
 .          150 North Union Street, Olean, NY 14760