PDF
Word
Form F-01647 Coverdell Emergency Medical Services (EMS) Partner Agreement - Wisconsin
What Is Form F-01647?
This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form F-01647?
A: Form F-01647 is the Coverdell Emergency Medical Services (EMS) Partner Agreement.
Q: What is the purpose of Form F-01647?
A: The purpose of Form F-01647 is to establish a partnership agreement between the Emergency Medical Services (EMS) provider in Wisconsin and the Wisconsin Department of Health Services.
Q: What is the Wisconsin Coverdell EMS Program?
A: The Wisconsin Coverdell EMS Program is a state-based partnership program that aims to improve the quality of care and outcomes for individuals who experience a trauma or cardiac event.
Q: Who should use Form F-01647?
A: EMS providers in Wisconsin who wish to participate in the Wisconsin Coverdell EMS Program should use Form F-01647.
Q: Are there any fees associated with Form F-01647?
A: No, there are no fees associated with Form F-01647 or participating in the Wisconsin Coverdell EMS Program.
Q: Are there any deadlines for submitting Form F-01647?
A: The Wisconsin Department of Health Services may set deadlines for submitting Form F-01647. It is recommended to check with the department for any specific deadlines.
Form Details:
- Released on July 1, 2021;
- The latest edition provided by the Wisconsin Department of Health Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form F-01647 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.
