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Southern Tier Health Care System, Inc.
  • Home
    • Our Mission
    • Our Team
    • Board of Directors
    • Our Facility
    • CEO Update
    • News
  • Our Programs
    • Emergency Medicine >
      • Current Provider Resources >
        • Education & Training
        • Annual Skills
        • EMS Agency Update
        • Applications & Forms
        • PCR Request
        • Protocols
        • Public Access Defib
      • Southern Tier EMT-B Academy
      • Paramedic Program
      • BEMS Portal Links
      • STEMS Newsletter Archive
      • Safe Transport
      • SWREMS, WREMAC & BEMS
    • Safe Kids >
      • Safe Kids Events
    • Cribs for Kids
    • Overdose Prevention >
      • Report Narcan Use
      • Narcan Training
      • Prescription Drug Safety
      • NY Matters >
        • Leave Behind Attestation
      • Drug Disposal Resources
    • Caregiver Navigation
    • Sexual Assault Forensic Examiner >
      • Become a SAFE Provider
    • Health Insurance
    • File of Life
    • Blood Drives
    • American Heart Association Training
    • Stop the Bleed
    • BRMC/OGH Food Service
  • Contact Us
  • Donate

​Applications & Forms

New Provider Information Required to come online
Agency Information Update Form
​
ALS Narcotics Forms
​
Blood Glucometry
​
BLS 12 Lead
​
Cattaraugus Co. CME Participant Tracking Form
​Check & Inject (Syringe Epinephrine)
​
CPAP
​
Ebola Preparedness Plan Sample Policy
​
ePCR Application
​
Epinephrine Auto-Injector Application
​Level of Care Change
​Medical Director Verification Form
​
Medical Director Change Form
​
MIST Report
​
Narcan Administration
​
Nebulized Albuterol
​Notice of AED use by PAD
​PCR Coversheet
PECC Application
​Preceptor Application
​
Prehospital Drop Sheet - excel
​
Prehospital Drop Sheet - pdf
Provider Privileges Application & Skills Evaluation Forms ​
​Voucher for Vital Signs
​
Tax Credit Form for Volunteer Fire Fighters and Ambulance Workers
​
800.21 General Requirements Checklist
© 2021 Southern Tier Health Care System, Inc. All Rights Reserved. 
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Southern Tier Health Care System, Inc.
​150 North Union Street, Olean, NY 14760

  • Home
    • Our Mission
    • Our Team
    • Board of Directors
    • Our Facility
    • CEO Update
    • News
  • Our Programs
    • Emergency Medicine >
      • Current Provider Resources >
        • Education & Training
        • Annual Skills
        • EMS Agency Update
        • Applications & Forms
        • PCR Request
        • Protocols
        • Public Access Defib
      • Southern Tier EMT-B Academy
      • Paramedic Program
      • BEMS Portal Links
      • STEMS Newsletter Archive
      • Safe Transport
      • SWREMS, WREMAC & BEMS
    • Safe Kids >
      • Safe Kids Events
    • Cribs for Kids
    • Overdose Prevention >
      • Report Narcan Use
      • Narcan Training
      • Prescription Drug Safety
      • NY Matters >
        • Leave Behind Attestation
      • Drug Disposal Resources
    • Caregiver Navigation
    • Sexual Assault Forensic Examiner >
      • Become a SAFE Provider
    • Health Insurance
    • File of Life
    • Blood Drives
    • American Heart Association Training
    • Stop the Bleed
    • BRMC/OGH Food Service
  • Contact Us
  • Donate