Patch Failure Form
Patient Safety Incident Report
RPPEO Forms
RPPEO Forms Page
Online Forms
The RPPEO provides paramedics with forms to help share specific information. Browse the forms below or use the site search function to locate a specific form. If you are a paramedic who is unable to find a specific form, please contact the RPPEO by phone or email.
Information that you provide to the RPPEO may be shared with paramedic services. This is consistent with the RPPEO's practices to improve transparency.
Do not include Personal Health Information when completing forms unless a form specifically asks for such information.
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Patient Safety incident Report Form
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Elective CME Approval Form
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Service Forms
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Data Request
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Training Needs Assessment Form
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MedicASK Submission Form
RPPEO Forms
Service Forms
Service Forms
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Certification Request Form
Paramedic colleges or paramedic service: download and complete this PDF to request the certification of a student or paramedic.
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Cross-Certification Referral Form
Updated April 18, 2023
For paramedics who would like to request cross-certification in the RPPEO region from another base hospital. Please submit one form for every Regional Base Hospital Program or certifying body within the past 10 years.
Please download and save this form, then submit by email.
Details within the PDF. -
Return to Clinical Practice
Paramedic services anticipating the return to work of a paramedic who has been away for 90 days or more, please complete this form to submit a Return to Clinical Practice request on behalf of the paramedic.