SOG Sample - EMS Patient Refusal Checklist

SOGLast updated Friday, April 5, 2019
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This patient refusal form can be used as a tool for personal and organizational protection when medical services and/or transportation are offered and refused.

Supplemental Resources

Technical Bulletin

EMS Patient Refusal Checklist - Spanish

Spanish EMS patient refusal checklist

Technical Bulletin

EMS Patient Refusal Checklist - English

EMS patient refusal checklist

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