This version of the State EMS Forms was posted on this site on 7/9/2010, and revised by the state on 10/15/2005 .

New Hampshire has implemented their web-based, statewide data system called TEMSIS (Trauma Emergency Medical Services Information System). It gives New Hampshire's 279 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.
The report writing feature allows agencies to define their own reports, publish them to several different formats, and schedule when the reports are to be run and delivered via email. This data mining tool is also available to the State for statistical analysis of the states 84,000+ annual runs.
Data entering into the system is scored utilizing a custom validity engine that analyzes the data for completeness. The TEMSIS system was developed for New Hampshire by ImageTrend, Inc.

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

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

The New Hampshire Division of Fire Standards & Training and Emergency Medical Services neither endorses nor recommends these forms but provides them as a sample for your use:

Sample Run Form(.PDF,12.48k)

Fire Department Information Sheet(.PDF,19.89k)

TEMSIS Implementation Plan 2005 (.PDF,191k)

TEMSIS Data Dictionary 3/2004(.PDF,716k)

NHTEMSIS Data Dictionary 2005(.PDF, 1504.59k)

TEMIS System Overview 12/2006 (.PDF,158.43k)

Click on the following links to view the corresponding files:

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