1425 South "D" Street
San Bernardino, CA 92415-0060
(909) 388-5823
(909) 388-5825  FAX
Mapquest: http://mapq.st/xIffkN

Executive Director
Virginia Hastings

Medical Director

Reza Vaezazizi, M.D.

Governing Board
Josie Gonzales, Chair
Brad Mitzelfelt, Vice Chair
Janice Rutherford
Neil Derry
Gary Ovitt


Hours of Operation:
Certification/Accreditation Hours
8:00 am to 4:00 pm, Monday-Friday

Business Hours
8:00 am to 5:00 pm, Monday-Friday

2012 Holidays - OFFICE CLOSED
:
January 2 & 16
February 20
May 28
July 4
September 3
October 8
November 12, 22 & 23
December 24, 25 & 31


Mission Statement

To ensure an effective system of quality patient care and coordinated emergency medical response by planning, implementing and evaluating an effective emergency medical services system including fire department and public ambulances, prehospital providers and hospitals, including specialty care hospitals, such as trauma and cardiac care hospitals.


Forms/Applications

Release Date
EMT Livescan Form2/16/2012
Specialty or EMT Optional Scope Program Application2/8/2012
Flight Nurse (FN) Application for Authorization1/30/2012
Mobile Intensive Care Nurse (MICN/MICN-A) Application for Certification1/30/2012
EMR Livescan Form2/16/2012
NSRC Application for Approval as an ICEMA Designated Stroke Center11/2/2011
EMT Training Program Approval Packet2/7/2011
CSAM Evaluation Form9/29/2011
STEMI Center Application for Designation7/11/2011
Drug & Equipment Inspection Form4/11/2011
A-EMT Application for Certification1/30/2012
Paramedic Training Program Approval Application Packet1/31/2012
EMT Application for Certification1/30/2012
EMR/FR Application for Certification1/30/2012
EMT-P Application for Accreditation1/30/2012
EMT-P Course Record8/3/2011
EMT Course Record12/8/2011
EMT Supplemental CE Form1/30/2012
Advanced EMT (AEMT) Training Program Approval Packet8/10/2011
EMT Skills Verification Form10/13/2011
EMS CE Provider Application for Approval1/30/2012
Change of Address or Employer Notification Form2/1/2011
CE Provider Monthly Reporting Log2/1/2011
Do Not Resuscitate (DNR)2/1/2011
CE Class Roster Form2/16/2012
Fire Line Paramedic Notification Form2/1/2011
Incident Report Form2/1/2011
MISS - Lost, Stolen or Damaged Equipment Form2/1/2011
Quarterly Declaration2/1/2011
Special Event Log2/1/2011
CALIF Approved POLST Form4/1/2011
ALS Provider Agency Changes in Personnel Quarterly Report Form1/30/2012
Duplicate Card Application1/30/2012

ICEMA Forms & Applications are in Adobe Acrobat PDF format.
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