Get Broselow Pediatric Tape Download 2020-2026

Filling out the Broselow Pediatric Tape Download form is a straightforward process that enables ambulance services to acquire essential pediatric emergency tapes. This guide will walk you through each step to ensure accurate completion and submission.

Follow the steps to complete the Broselow Pediatric Tape Download form.

1. Press the ‘Get Form’ button to access the Broselow Pediatric Tape Download form and open it in your preferred editor.
2. Enter the EMS service name in the designated field to identify the service requesting the tapes.
3. Provide the mailing address for your EMS service, ensuring all details are accurate for proper delivery.
4. Fill in the city, state, and zip code associated with your service's address.
5. Indicate the total number of EMS staff at your service, as this information is essential for processing your request.
6. List the number of EMS staff who have completed the Broselow Pediatric Tape Training course to confirm eligibility.
7. Specify the number of Broselow Pediatric Emergency Tapes you are requesting, keeping in mind the limit of five per service.
8. Confirm that at least 50% of your EMTs have completed the online training by stating this in the appropriate section.
9. The EMS Service Manager should sign the form to authenticate the request.
10. Enter the date on which the form is completed to ensure the request is timely.
11. Once all sections are filled out, review the form for accuracy. Save your changes, download a copy, and submit it to the MT EMS for Children Program via fax or email.

Complete your Broselow Pediatric Tape Download form online today to secure essential emergency resources for your ambulance service.