Region X Protocols
To download Region X Protocol App to a mobile device, click the appropriate link below:
To be completed 60 days prior to IDPH expiration if NMnrEMSS is your Primary EMS System:
1. Pay IDPH fee via online payment portal and PIN number received in the mail. Save proof of payment receipt.
2. Verify completion of all System Requirements on EMS1 >> My Dashboard >> Assignments >> Credential Training 100%
3. Complete IDPH License Renewal Form
4.Complete NMnrEMSS License Renewal Request
5. Submit completed packet to your Medical Officer for verification:
- NMnrEMSS License Renewal Request
- Proof of IDPH payment
- IDPH License Renewal Form
- Valid AHA BLS CPR card
- 100 hours of System approved CE
NMnrEMSS Renewal Request Form
To be submitted with your completed packet by your department Medical Officer to NMnrEMSS.
IDPH License Renewal Form
For license renewal, a Renewal/Child Support form must be submitted. Download here
IDPH Online Payment Portal
Once paid, save the recipt of payment to submit with your renewal application to NMnrEMSS.
NREMT License Renewal Request
To be completed by March 1 of expiration year
1. Ensure you are affiliated with Northwestern Medicine Lake Forest Hospital
2. From My Certification Dashboard follows steps 1, 2, & 3 to input CE hours
3. Pay for re-licensure through NREMT website
4. Email email@example.com to notify your file is ready for renewal
Letter of Good Standing and CE Report Request
In order to transfer Primary or Secondary Affiliation from North Region EMS System to another System, NMnrEMSS must send a Letter of Good Standing and Continuing Education report to your new System. Please submit this request and allow up to 30 days for processing. Submit to EMS System Coordinator Evert Gerritsen via email:
Request for Clarification
To request clarification of patient care or provider/hospital communication, please download and submit to EMS System Coordinator Evert Gerritsen via email:
Ambulance Equipment Restock Form
For ambulance equipment restock, please fill out attached form and submit to EMS System Coordinator Evert Gerritsen via email.
Please ensure the alternative point of contact listed is a department employee that works weekdays or is a department number with a voicemail account that is checked regularly.
Pharmacy Restocking Form
For expired medication exchange, or non-transport exchange, please fill out attached form and submit to EMS System Coordinator Evert Gerritsen via email.
IDPH Ambulance Inspection Form
For ALS transport vehicles, inspections include the attached IDPH inspection form and the NMnrEMSS ALS Non-Transport form.
ALS Ambulance Inspection Form
ALS Ambulance NMnrEMSS Equipment and Medications List
ALS Non-Transport Inspection Form
ALS Engine/Squad NMnrEMSS Equipment and Medications List
If you are an out-of-state EMS provider needing to apply for your Illinois License, please download and submit. Ensure you sent in the completed packet all at once. Failure to do so will result in rejection and the need to begin the process again.
License Extension Request Application
If you are unable to complete the required Continuing Education hours by your license expiration, you may file an Extension Request Application with IDPH prior to expiration.
Inactive License Request Application
To request inactive status on your IDPH license, submit form to IDPH and notify NMnrEMSS.
Reactivation Request Application
If your IDPH license has been de-activated and you are ready to reactivate, please complete this form and send a reactivation request to firstname.lastname@example.org
Special Event Application
In order to provide EMS care for a Special Event, this form must be submitted 45 days prior to the event.
Training Program Application
In order to receive credit for courses completed in-house, an EMS Training Program form must be submitted annually for your department.