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Emergency Medical Services (EMS) Forms

  • EMS Office Forms 


EMR / EMT / Paramedic Application Forms and Documents
  • Acknowledgement of Receipt of 2017 Pierce County
  • 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
      Pierce County

      Contact Us

      1. Pierce County
        930 Tacoma Avenue S
        Tacoma, WA 98402
        Contact Us

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