BEMS Policies

• 12-02 Prehospital Care Reports (PDF)
• 12-03 Electronic PCR Data Submission (PDF)
• 21-04 Submission of Patient Care Reports as of July 1st, 2021 (PDF)
• NYSDOH 5136 Form

WREMAC Refusal Form

• WREMAC Refusal of Evaluation, Treatment, & Transport Form
• ​Request Printed Refusal Forms

Prehospital Care Report

*due to BEMS policy statement ​​21-04 (above), STEMS is no longer able to distribute paper PCRs and continuation forms. 

• Printable PCR
• Agency Copy (White Copy) - Front
• Agency Copy (White Copy) - Back
• Research Copy (Yellow Copy) - Front 
• Research Copy (Yellow Copy) - Back 
• Hospital Copy (Pink Copy) - Front 
• Hospital Copy (Pink Copy) - Back 
• DOH-3411 - Continuation Form

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