Forms for Your Team

Manikin Clipboard

For teams of any size and of any type, it’s a great idea to keep health information available that might be critical to EMT or other first responders.  We have provided a downloadable health form, as well as a Privacy Protocol for keeping the information confidential.


  1. Have an Envelope and a Health History form for each of your team members.envelope
  2. On each envelope, either print or print on stickers to place on the envelopes, the envelope statement below.
  3. Each member of your team should fill out a Health History form and place that form inside of an envelope that may be sealed.
  4. Those envelopes should be kept in the charge of your team’s Safety Lead or Team Leader in case of emergency.


Envelope Statement:

To be printed on the outside of the sealed envelope, or may be printed onto a sticker to be placed onto the envelope.  A PDF file is provided below.

env form
Click to open PDF file.










Health History Form:

This form is clickable and will open in PDF format.

Health History form
Click to open PDF file