The patient transfer of care form is required by the EMS Act and Rules and Regulations. The Department requires the primary care provider to provide a report with the receiving facility at the time of the patient's transfer of care. The report must be given verbally and in a written format. This form provides the minimum data elements required to be provided at the time of the patient's transfer of care. While an EMS agency may create their own form, the EHSF encourages the use of this regionally accepted form for familiarity by the EMS providers and hospital personnel receiving the patient.
Patient Transfer of Care