Background:

The Department of Health (DOH) is requires reporting of EMS Service contact information for matters related to WEMSIS data and reporting. (RCW 246-976-455, 3.d.)

Please Consider:

When completing the form for the first purpose, all information you provide will replace information from previous form submissions or the current list of contacts. Please include all authorized individuals who currently receive reports.

The completion of this form does not automatically generate WEMSIS accounts for authorized data users. Contact WEMSIS@doh.wa.gov to request accounts for individuals named in this form.