This version of the State EMS Forms was posted on this site on 08/13/2010, and revised by the state on 09/20/2005.

This ongoing project is funded by The Duke Endowment through an applications and database agreement to the EMS Performance Improvement Center by the South Carolina Department of Health and Environmental Control, Division of EMS and Trauma. This project supports the development, implementation and maintenance of the South Carolina EMS Data System, including the PreMIS, CIS and SMARTT web applications. As of January 2010, all South Carolina EMS agencies have been enrolled and trained in the PreMIS system and many are actively submitting data.

Beginning January 1, 2010, the Department will not accept or provide paper run reports. This action will reduce staff time and the cost of printed materials. Licensed transporting EMS Agencies not submitting electronic patient report data after December 31, 2009 will be deemed in non-compliance with Regulation 61-7, Section 1302.A and the Department will initiate appropriate action which may include a monetary penalty.

Patient Care Form rev, 1/2004  NOTE: The SC DHEC 1050 forms will no longer be available after December 31, 2009.

PreMIS Preliminary Report version 2

South Carolina EMS Patient Care Form Completion Instructions - 2004(.PDF,320k)

South Carolina EMS Patient Care Form 1/2004, Page 1(.PDF,18.9k)

South Carolina EMS Patient Care Form  1/2004, Page 2(.PDF,15.5k)

South Carolina EMS Forms Control Officer Responsibilities(.PDF,282k)

South Carolina Pre-hospital Information System (SCPIS) Data Element List 10/2006(.PDF,170.93k)

South Carolina EMS Data Dictionary 5/2008 (.PDF,2443.24k)

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