IN AN EMERGENCY DIAL 9-1-1

UGYFD SOP’s.

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Table of Contents

200-299 By-Laws / Rules / Administrative / General

200.00 Bylaws 08-13-20

201.00 Alcohol and Drug Testing

202.00 Post Accident Alcohol and Drug Testing

203.00 Life Safety Rope (Lifeline)

203.01 Turn Out Gear Specifications

203.02 Helmet Specifications – Helmet Front Uniformity

205.00 Personnaly Owned PPE Authorization Form

207.00 Training & Continuing Education Program

207.01 Training & Continuing Education Request and Reimbursement Agreement

207.02 EMS Authorization Form UGYFD (fillable) 06-16

207.03 FIRE Authorization Form UGYFD (fillable) 06-16

209.00 Records and Forms

210.00 Fire Motor Vehicle Report

210.01 First in Report

210.02 Acquired Vehicle Permission Form

211.00 Interview of New Candidates for Membership

212.00 Membership & Intern Application Flow Matrix

212.01 Membership Employment Application

212.02 DHFS Background Information Disclosure Form

213.00 New Member Handbook

213.01 Issued Equipment Inventory

213.02 FH New Member Information

213.03 Confidentiality Statement

214.00 Code of Conduct (Professional Relations, Media Relations and Social Media)

214.01 Social Media article Fire Chief 07-2012

215.00 Uniform Dress Code

215.01 Lark Uniform Request

216.00 Facial Hair Policy (SCBA)

216.01 Personal Appearance, Hair Length, Jewelry

217.00 Personally Owned Vehicle (POV) Lights & Siren

217.01 Personally Owned Vehicle (POV) Inspection & Responsible Use Agreement

217.02 Personally Owned Vehicle (POV) Proof of Insurance Form

218.00 Annual Review of Driving Record Certification of Violations

218.01 US DOT FMCSA

219.00 Workplace Harassement & Complaint Procedure Policy

219.01 Workplace Harassement Complaint Form

221.00 Leave of Absence Policy

221.01 Leave of Absence Request Form

222.00 Vacation Policy

222.01 Vacation Policy Form

225.00 LODD

225.01 Emergency Information Worksheet

225.02 PSOB Beneficiaries Designation Form

226.00 VFIS Handbook of Insurance Benefits & Beneficiary Form

226.01 VFIS Beneficiary Form

227.00 Incident Response Requirement

228.00 Compensation Paid on Call Plan

228.01 Compensation (Memo 04-17-04 Time Punch – Fire Calls MVA)

228.02 FH Personnel Incident Response Sign In Sheet

228.03 FH Personnel Business Training Activity Sign In Sheet

228.04 Associate Time Sheet.pdf

230.00 Janitorial Job Description 8-29-05

231.00 Clerical Job Description 10-01-00

232.00 AC EMS  Job Description 04-05-11

240.00 State of Wisconsin Act 140, 2009

240.01 Excused Absence From Work Form

240.02 Employer Letter (example)

245.00 Disciplinary Action Policy

250.00 Officer Qualities, Requirements & Expectations

280.00 Associate Membership Program

280.01 Associate Membership Program Yearly Renewal Agreement

280.02 Weekly EMS Fire Intern Associate Station Duties

280.03 Student Intern Membership Program

280.04 Student Intern Membership Program Agreement

400-499 EMS Emergency Medical Services

400.00 Patient Care Protocols 2019

400.03 Lidocaine Drip Administration Guidelines

402.00 Ambulance New Member Rules & Candidate Riding Assignments

402.01 EMS Ride Along Program

402.02 EMS Ride Along Request Form

405.00 Medical Control & Quality Management Program

407.00 Racine Area EMS – On Scene Worksheet

410.00 Decontamination – BBP

420.00 Duty Group Response

425.00 Daytime Schedule Program

430.00 CPR Instruction

450.00 EMS Dispatch and Response Policy

450.01 Tiered Dispatch Guideline

455.00 Hospital Destination Determination

455.01 Billing Authorization & Privacy Acknowledgment Signature Form (rev. 01-08) Use pg 1 only

455.02 Notice of Privacy Practices (rev. 12-07)

460.00 EMS Response Cancellation

465.00 EMS Patient Refusal

465.01 Release of Liability Form

465.02 Multiple Patient Release Form

470.01 Discharge Tracking Record – Incident Command

470.02 Discharge Tracking Record – Medical Unit

470.03 Participation Release of Liability and Indemnity Agreement

475.00 Controlled Substance Policy Procedure

475.02 Record of Seal Replacement

475.10 Dilaudid 333 Inventory Log

475.11 Dilaudid 334 Inventory Log

475.12 Dilaudid 335 Inventory Log

475.13 Fentanyl 333 Inventory Log

475.14 Fentanyl 334 Inventory Log

475.15 Fentanyl 335 Inventory Log

475.16 Lorazepam/Ativan 333 Inventory Log

475.17 Lorazepam/Ativan 334 Inventory Log

475.18 Lorazepam/Ativan 335 Inventory Log

475.19 Morphine 333 Inventory Log

475.20 Morphine 334 Inventory Log

475.21 Morphine 335 Inventory Log

475.22 Valium 333 Inventory Log

475.23 Valium 334 Inventory Log

475.24 Valium 335 Inventory Log

475.25 Versed 333 Inventory Log

475.26 Versed 334 Inventory Log

475.27 Versed 335 Inventory Log

480.00 Orientation of EMS Members

480.01 Orientation of EMS Members – Orientation Form

480.02 Orientation of EMS Members – Patient Encounter, Run Evaluation Form

490.00 Patient Request for Access to Medical Records Form

 

 

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