Banner Image - Paramedics and Firestations Banner Image - Arrowhead Regional Medical Center and Loma Linda University Medical Center Banner Image – Emergency Medical Service Banner Image - Helicopter Rescue Banner Image – Loma Linda University Medical Center Helicopter Banner Image - Great American Shakeout Drill Banner Image - Ambulance at a Fire Banner Image – Airplane Accident Rescue Banner Image - Firefighters at Accident Scene Banner Image – Firefighter at Apartment Fire Banner Image - Boyscout Training with Helicopter Crew Banner Image - Mercy Air Rescue Banner Image – Winter Rescue Banner Image - Training Exercise Banner Image – Training Exercise Banner Image - Mercy Air Loading Patient into Helicopter Banner Image - Helicopter on Ground Loading Patient Banner Image – Highway Car Accident Banner Image - Highway Car Accident Banner Image – Mercy Air Helicopter Banner Image - Paramedics with Gurney Banner Image - Patient with Bloody Leg Banner Image – Red Cross Banner Image – Swift Water Rescue Banner Image – H-82 Flying

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

EMS Administrator
Tom Lynch

Medical Director

Reza Vaezazizi, MD

Governing Board
Janice Rutherford, Chair
Robert A. Lovingood
James Ramos
Gary Ovitt
Josie Gonzales


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


Certification/Accreditation Hours:
Monday-Friday 8:00 am to 4:00 pm*


*Excluding Holidays


2014 Holiday Schedule:

May 26, July 4,
September 1, October 13,
November 11, 27 & 28,
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
2013/2014 EMS Aircraft Permit Application Form9/10/2013
A-EMT Course Record5/10/2012
Advanced EMT Certification7/1/2013
Advanced EMT Recertification7/1/2013
ALS Provider Agency Changes in Personnel Quarterly Report Form1/30/2012
CALIF Approved POLST Form4/1/2011
Change of Address or Employer Reporting Form3/1/2012
Continuing Education Class Log Monthly Report Form3/1/2012
Continuing Education Class Roster Form5/15/2012
Continuing Education Provider (CEP) Application for Approval Form1/24/2012
Coroners Worksheet of Death - EMS Report of Death Protocol Reference #120109/13/2012
CSAM Evaluation Form9/29/2011
Drug Shortage Waiver Request Form5/16/2013
Duplicate Card Application1/17/2013
Emergency Medical Responder (EMR) Course Record5/12/2012
Emergency Medical Responder (EMR) Training Program Approval Packet7/1/2013
EMR / FR Initial Certification7/1/2013
EMR / FR Recertification7/1/2013
EMR Livescan Form2/16/2012
EMS MISS Toughbook Damaged, Lost or Stolen Equipment Report Form8/9/2012
EMT Course Record5/10/2012
EMT Initial Certification7/1/2013
EMT Livescan Form2/16/2012
EMT Recertification7/1/2013
EMT Skills Verification Form10/13/2011
EMT Supplemental CE Form1/30/2012
EMT Training Progarm Approval Packet7/1/2013
EMT-Paramedic Accreditation7/1/2013
EMT-Paramedic Training Program Approval Packet1/8/2014
Fire Line Paramedic Deployment Notification Form8/9/2012
Flight Nurse Authorization7/1/2013
Hospital Patient Dashboard and Special Registry List of Users Form9/9/2013
HPP Reimbursement Training1/15/2013
ICEMA DNR Form8/9/2012
MICN Certification7/1/2013
MICN Course Record9/10/2012
MICN Training Program Approval Packet9/10/2012
NSRC Application for Approval as an ICEMA Designated Stroke Center11/2/2011
Patient Care Record (PCR) ICEMA Run Report Paper Form 01A10/1/1991
Personnel Authorized to Verify Skills Competency3/1/2012
Quarterly Declaration8/8/2013
Special Event Ambulance Providers - SE Treatment Log Form8/9/2012
Speciality and Optional Scope Program Approval Application8/9/2012
STEMI Center Application for Designation7/11/2011
Submersion Incident Report Form SIRF (For Reporting all Drowning or Near Drowning Incidents in San Bernardino County)9/17/2013

ICEMA Forms & Applications are in Adobe Acrobat PDF format.
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