This version of the State EMS Forms was posted on this site on 08/28/2007, and revised by the state on 06/12/2006. Last updated 6/22/2006.

Minnesota has a web-based, statewide data system called MNSTAR (Minnesota Statewide Ambulance Reporting), which went online on April 1, 2003. It gives Minnesota's 256 agencies the flexibility to collect their own data and then upload to the state via XML or enter their runs via a web browser using an online run form. This state-of-the-art system has positioned Minnesota into a national leadership position in EMS data collection.

Minnesota has been submitting to NEMSIS since January of 2006. The State has 100% of the state agencies are submitting all runs. Minnesota is currently collecting 91% of the NEMSIS elements in their state database.

Per the EMSRB Bulletin, September - October 2006. Executive Director Mary Hedges announced

"In early October, several from the EMSRB attended the National Association of State EMS Officials (NASEMSO) conference in Charleston, West Virginia. We were honored at the conference to receive an award from the National EMS Information System (NEMSIS) Technical Assistance Center to be the first state to regularly submit EMS data to the new national database. This was a welcome recognition to EMSRB staff and EMS providers in Minnesota who have been committed to creating a quality statewide EMS data collection system."

"At the May 17, 2007 Board meeting, a motion was passed that will require all ambulance services to be compliant with the current EMSRB/NHTSA/NEMSIS 2.2 data set and XML file format requirements by September 1, 2008. Ambulance services uploading ambulance run data to MNSTAR in the old 1.0 data set under various file formats will be required to be transitioned to the current 2.2 data set and XML file format by the 2008 date. "

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

These form were used prior to 2006

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

EMSBR Patient Care Report Form v 2.3 revised 2/22/2006 (.PDF,165.63k)

EMSRB Patient Care Report supplemental (.PDF.457,88k)

EMSBR Data Dictionary 3.0.1( .PDF,90.63k)

EMSBR NEMSIS-NHTSA 2.2 Data Dictionary 3.0.2 revised 4/5/2006(.PDF,85.99k)

MNSTAR – Data Dictionary Definitions Supplement added 03/14/2007 (.PDF, 212.90k)

Click on the following links to view the corresponding files:

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