Get Venipuncture Form For Entry Into Emt-iii Training Programs - Dhss Alaska

Filling out the Venipuncture Form for entry into EMT-III training programs is an important step in your journey to becoming an emergency medical technician. This guide provides clear instructions to help you complete the form efficiently and accurately.

Follow the steps to successfully complete the Venipuncture Form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Section A, fill in your name as the applicant. Ensure that all entries are accurate and clearly legible.
3. Provide your Alaska EMT-2 certification number to verify your credentials. Double-check to make sure this number is correct.
4. Enter the name of your EMT-3 course instructor and the corresponding course number. This information is crucial for proper identification.
5. Indicate the start date of your EMT-3 course. Ensure this date is accurate to avoid any discrepancies.
6. Move to Section B, where you will note down the venipuncture information. Fill in the date of the procedure.
7. The witness, certified at EMT-2 level or above, must provide their signature and indicate their level of training in this section.
8. Specify the type of needle used for the venipuncture as either catheter-covered or other, providing details if necessary.
9. Document the venipuncture site and ensure all entries are clear and concise.
10. Record the age and gender of the recipient, ensuring that this information is accurate.
11. Review all entered information for accuracy and completeness before proceeding.
12. Once satisfied with the form, save your changes and make sure to download, print, or share the form as needed.

Complete your documents online and take the next step in your EMT-III training.