This version of the State EMS Forms was posted on this site on 6/22/2010, and revised by the state on 12/02/2005.

Michigan began submitting to NEMSIS in October of 2009. Currently 74% of Michigan's EMS agencies are submitting to their state database. Michigan is submitting 100% of the NEMSIS National Dataset.

Michigan's EMS data repository is an all inclusive system.  ImageTrend has been selected as Michigan's statewide data repository (this is where all data will be uploaded).  There are 430 demographic and EMS data elements in the National EMS Information System (NEMSIS) Gold XML data file.  This represents all of the elements located in the NEMSIS Data Dictionary.  Anyone submitting data to ImageTrend should do so by importing or sending the NEMSIS XML file.  This does not mean all 430 elements must be collected for every call or even at all.  It just means that any NEMSIS data elements collected shall be submitted to the repository.

All Michigan EMS agencies should be collecting electronic patient care information for all EMS dispatches in a NEMSIS Gold Compliant system by April 1, 2009.

Agencies not using ImageTrend State Bridge should be submitting the information to the State Bridge system by the 15th of each month with the previous months records. Therefore, the information collected for the month of April, 2009 should be uploaded to the State Bridge system by May 15, 2009.


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

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

MI-EMSIS PCR Elements v1.1 6/2009 (.PDF,k)

NHTSA EMS Assessment 5/2007 (.PDF, 175.09k)

Click on the following links to view the corresponding files:

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