Seal of Dane County County of Dane
Dane County Emergency Management

Forms & Links


The following forms are for use by EMS District Directors, Training Directors, or designees. Forms that can be completed and submitted online will require a password; the password may be obtained by calling the Dane County EMS office at (608) 266-4387. Otherwise, the forms will require MS Word or Adobe Acrobat.

Upon completing the MS Word and Adobe forms, print, sign, and fax to the Dane County EMS office at (608) 266-4500.

Helpful Hints: When completing MS Word electronic forms, use the tab key or arrow keys to navigate within the form. Press the space bar to 'check' a box. Call the Dane County EMS office if you need further assistance.

Make sure all proper signatures are included on the forms at the time of submission.

Adobe Acrobat:

Mobile Command Center (CV-1) Non-Emergency Request Form
Member Info and Drivers License Review Form
10 Delta Auto-ALS Project Summary
District Sponsored Training Roster
Priority Medical Dispatch Feedback Form
Field Feedback Report
Application for Service Medical Director
Advanced Airway CQI
Base Hospital/Transportation Log
(if needed in an editable format, please contact our office)
Auto ALS Review - EMT/AEMT
Auto ALS Review - Paramedic

MS Word:

Subcommittee Application
Application for Volunteer Employment (Sample)
First Report of Injury
Member Termination
Quality Assurance (QA) Report
Quality Assurance (QA) Report (Detailed Instructions)
Quality Improvement (QI) Data Collection Sheet