Get Doh 2828

The Doh 2828 form is essential for documenting personnel within emergency medical services. This guide provides clear instructions on how to complete this form online, ensuring accurate and efficient processing.

Follow the steps to successfully complete the Doh 2828 form.

1. Click 'Get Form' button to obtain the form and open it in your online editor.
2. Begin by entering the agency name in the designated field. Ensure the spelling is accurate to maintain proper identification.
3. Input the agency code in the next field, which serves to uniquely identify your EMS agency.
4. Enter the date submitted in the format MM/DD/YYYY, ensuring compliance with the specified date format for clarity.
5. List all personnel alphabetically by last name, starting with the first entry. For each staff member, fill in their first name next to their last name.
6. For each person, include their date of birth (DOB) in the format MM/DD/YYYY.
7. Indicate whether the personnel is DOH certified and provide their DOH issued ID number.
8. Record the expiration date of their certification in the same MM/DD/YYYY format.
9. Select the level of certification for each person by checking the appropriate box. Options include CFR, EMT, AEMT, CC, and P.
10. If applicable, check any additional levels of training or certifications they have received, such as CPR/AED or First Aid.
11. After completing all required fields, review the form for accuracy. Save changes, then download, print, or share the completed document as needed.

Complete your Doh 2828 form online today for efficient processing.