This version of the State EMS Forms was posted on this site on 2/09/2009, and revised by the state on 06/08/2006. Last revised 08/18/2010.

Iowa began submitting to NEMSIS in January of 2007. Currently 82% of Iowa's EMS agencies are submitting 90% of their data to their state database. Iowa is submitting 100% of the NEMSIS National Dataset.

Click on the thumbnails below to view a full sized image.

Iowa Patient Care Report Form

Iowa Patient Transfer of Care Form

Select the following to view a printable Acrobat (.PDF) version. 

Iowa EMS Patient Data Dictionary v1.4  2/2005 (.PDF,784.00k)

Iowa EMS Patient Data Dictionary v2.0  12/2006 (.PDF,1389.40k)

Iowa EMS Patient Data Dictionary v2.2.1  8/2007 (.PDF, 1441.24k)

NEMSIS Compliant Data Element List effective 7/2007 (.PDF,41.56k)

Click on the following links to view the corresponding files: