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Event Medicine Forms  
Below are copies of the Event Medicine Protocol v10.10 and forms which are now required for any events requesting to be staffed by MCEMS personnel and covered by the EMSMD’s medical license.

Event Medicine Forms

Icon MCEMS Event Medicine - Application Form
  • This application for your event, and personnel roster, must be filled out, SIGNED, and returned to the EMSMD at least 14 days before the event- the earlier the better.
  • Your Event is NOT covered by the EMSMD’s Medical License until you have submitted this AND heard back from the EMSMD that all is in order.
Icon MCEMS Event Medicine - Patient Contact Forms
  • These are the “SOAP notes” and Refusal Forms to be used at all Event’s covered by the EMSMD.
  • There are detailed instructions on this form- READ THEM!
Icon Non EMS Agency Event Medicine v10.10

I instituted a new Event Medicine protocol in October, 2010. This is a copy of that protocol.





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