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Emergency Medical Services (EMS) Forms

  • EMS Office Forms 


EMR / EMT / Paramedic Application Forms and Documents
  • Acknowledgement of Receipt of 12-2021
  • EMR and EMT Initial Checkoff 12-2021
  • EMR and EMT In-State Transfer Checkoff 10-2020
  • EMR and EMT Reciprocity Checkoff 6-2020
  • PM Upgrade or Initial - WA Trained - Checkoff 1-2019
  • PM In-State Transfer Checkoff 10-2020
  • PM Reciprocity Checkoff 6-2020
EMS Evaluator (ESE) Renewal
  • WA DOH EMS Evaluator (ESE) Partial Online Renewal Option
  • Pierce County EMS MPD Specific Reminders for ESE Renewal
  • Skills Competency for ESE Renewal Only Form
Paramedic Continuing Education / Skills Record
  • First Certification Period
  • Subsequent Certification Periods
  • Paramedic Reciprocity Skills Verification
Miscellaneous Forms
  • Pierce County AED Registration Form
  • Pierce County OTEP Summary Form
  • Revised Washington State DOH Training, CME and Skills Maintenance Documentation
  • Personal Status Changes
  • Protocol Change Request Form
  • Suggest Topics for EMS Conference
  • Ambulance/Aid Equipment List
  • Portable Order for Life Sustaining Treatment (POLST)
     To order POLST forms or brochures visit the WSMA website




      1. EMS_clean

         Pierce County EMS Office



        2501 S. 35th St. Suite D
        Tacoma, WA 98409

        For emergencies:
        Call 9-1-1

        Ph: (253) 798-7722
        Fx: (253) 798-2200

        Contact Us



        Hours


        Monday - Friday
        8 a.m. – 4 p.m.


        DEM FacebookEmergency Information BlogPierce County Twitter

      1. EMS Council
      2. EMS Forms
      3. Other Publications

      How can we help?

      1. Pierce County wants to hear from you. Please select one of the following to talk to elected officials and staff, or to report problems in our community.

      1. Send a message
      2. Report an Issue
      1. File a Police Report
      2. Property Information
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      1. Emergency Management Logo

      Contact Us

      1. 2501 S. 35th  St. Suite D
        Tacoma WA 98409
        Contact Us

        Ph: 253-798-6595
        Fx: 253-798-3307

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      1. Contact Us
      2. PC Alert
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