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Region X Protocols
To download Region X Protocol App to a mobile device, click the appropriate link below:
Android: https://www.acidremap.com/customAppDownload.php?bundleID=PPPRegionXEMSProtocols&platform=android
iOS: https://www.acidremap.com/customAppDownload.php?bundleID=PPPRegionXEMSProtocols&platform=iOS
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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:
evert.gerritsen@nm.orgLicense Renewal Request
To be completed 60 days prior to IDPH expiration if NMnrEMSS is your Primary EMS System:
1. Pay IDPH fee via online payment platform and PIN number received in the mail
2. Verify completion of all System Requirements on EMS1 >> My Dashboard >> Assignments >> Credential Training 100%
3. Complete IDPH EMS Renewal Notice
4. Download attached form and submit with current copy of AHA CPR Card to your Medical Officer
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:
evert.gerritsen@nm.orgNREMT 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 evert.gerritsen@nm.org to notify your file is ready for renewal
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Ambulance Equipment Restock Form
For ambulance equipment restock, please fill out attached form and submit to EMS System Coordinator Evert Gerritsen via email.
evert.gerritsen@nm.org
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.
evert.gerritsen@nm.org
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For license renewal, a Renewal/Child Support form must be submitted. Download here
If you are an out-of-state EMS provider needing to apply for your Illinois License, please download and submit.
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.
To request inactive status on your IDPH license, submit form to IDPH and notify NMnrEMSS.
If your IDPH license has been de-activated and you are ready to reactivate, please complete this form and send a reactivation request to evert.gerritsen@nm.org
In order to provide EMS care for a Special Event, this form must be submitted 45 days prior to the event.
In order to receive credit for courses completed in-house, an EMS Training Program form must be submitted annually for your department.
