Policies, Documents, Forms and Meeting Minutes

EMS Policies (New!)

Examination Accommodations: This policy describes the process for requesting an accommodation on an EMS psychomotor examination

Exam Accommodations Questionnaire

Substantiated Report of Abuse (Adult Abuse Registry and Child Protection Registry): This policy describes how the Vermont Department of Health addresses substantiated reports of abuse by EMS licensees and applicants

False Answers on License Applications: This policy addresses cases where an EMS licensee or applicant provides false answers to the self-disclosure questionnaire on license applications

Impaired or Negligent Vehicle Operation: This policy describes how crime convictions for impaired or negligent driving convictions affect a person's eligibility for EMS licensure

Pending Criminal Charges: This policy describes EMS licensees' and applicants' obligation to disclose criminal charges and convictions

Challenging the NREMT Exams - RN/PA/Military Medics: This policy describes the process that allows a Registered Nurse, Physician Assistant or Military medic to obtain a National Registry certification and state license without taking an initial course.

EMS Agency Administration

EMS Rule (effective February 1, 2022)
Vermont Statewide EMS Protocols - 2023 Version
Vermont Statewide EMS Protocols - 2020 Version (Effective May 15, 2020)
Vermont EMS District Map
Agency License Level Change Application: Log into the LIGHTS Public Portal (Applications > Service Applications)
First Response Agency Recommended Equipment Lists
- EMR
- EMT
- AEMT
- Paramedic
Vermont Ambulance Equipment List (Updated July 5, 2022): This list is based on the National Equipment List for Ambulances and modified to adhere to Vermont’s Statewide EMS Protocols.
GSA Ambulance Design Specifications (KKK-1822F): This document describes the required specifications for all Vermont licensed ambulances. See GSA Change Notices for new requirements issued by the GSA since publication of this document
SIREN Downtime Run Form: Use this form to record EMS incidents in the event that the SIREN system is not available.
Vermont EMS Stroke Alert Screening Tool
Rule or Regulation Waiver Request - General: Log into the LIGHTS Public Portal (Applications > My Applications) if you would like to obtain a waiver of any section of the EMS Rule.
Rule or Regulation Waiver Request - Research: Log into the LIGHTS Public Portal (Applications > My Applications) if, as part of a research project, you would like to obtain a waiver of any section of the EMS Rule.
Agency License Application - Sample Operational Letter of Agreement: This is a template for an Operational Letter of Agreement, which is a requirement for obtaining an EMS agency license.
Agency License Application - Sample Public Notice & Instructions: This is a template for posting a public notice in local newspapers when applying for a new EMS agency license.
Ryan White CARE Act Provision: This document provides guidelines for exposure to infectious diseases.

Instructor/Coordinator Resources

AEMT Testing and Licensing Information: This document guides AEMT instructors on course completion requirements, preparing students for National AEMT testing and applying for Vermont AEMT licensure.
EMS Student Manual: This manual provides important information to students in initial EMS courses about course logistics and prepares them for examinations and licensure.
Peer Mentor Evaluation Form - Presentation (I/C Bridge Course): Use this form if you are an existing Instructor/Coordinator who is mentoring/evaluating a student in an I/C Bridge Course. A separate form must be completed for each presentation the I/C Bridge candidate leads.
Peer Mentor Evaluation Form - Comprehensive (I/C Bridge Course): Use this form if you are an existing Instructor/Coordinator who is mentoring/evaluating a student in an I/C Bridge Course. This form is to be completed as an overall assessment of the candidate after he or she has delivered all presentations.
Instructor/Coordinator Administrative Guide: NOTE: This guide is currently being revised. If you have questions, please contact State Training Administrator Bambi Dame.
Vermont EMS Rapid Sequence Intubation Course Manual: This manual outlines the RSI education and CQI program requirements for both RSI paramedics and RSI assistants.

Practical Exam Site Resources

Exam Coordinator Guide: This manual provides comprehensive information to help exam coordinators plan and execute a successful EMS practical exam site. NOTE: This guide is currently being revised. If you have questions, please contact State Training Administrator Bambi Dame.
National Registry Practical Exam Score Sheets - EMR, EMT, AEMT and Paramedic: These are the practical exam scoring sheets used at all Vermont EMS practical exam sites.

Become a HEARTSafe Community

Refer to the documents in this section to apply to become a Heart Safe Community:

Please send completed HEARTSafe applications to the Vermont EMS Office by emailing [email protected] or by mailing to Vermont EMS, PO Box 70, Burlington 05402-0070.

Public Access Defibrillation (PAD)

PAD Registration Form: Use this form to notify the Vermont Department of Health that a public access defibrillator has been placed at your location.
PAD Legislation: This is the text of legislation that created the Public Access Defibrillation program and provides instructions for registering defibrillators with the Vermont Department of Health.

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Meeting Minutes

EMS Advisory Committee

Monthly EMS Leadership Conference Calls