EMS Wristband Project Requests

TEXAS EMS WRISTBAND PROJECT: WRISTBAND REQUEST
     NCTTRAC has partnered with other RACs in developing a statewide wristband program to link pre-hospital and hospital records for both disasters and across the continuum of care. The EMS Committee has voted to purchase additional wristbands using a portion of the funds from the Local Projects Grant (LPG) awarded by Texas Department of State Health Services for TSA-E.

     Each EMS agency will receive wristbands equal to the amount of one half of the recorded EMS runs reported to DSHS from the previous year, on a first come, first served basis.

     Note: the wristbands will be distributed on a first come, first served basis, and only to DSHS-licensed EMS agencies. Hospitals must contact their local EMS agency enrolled in the project for additional wristbands.
Requesting Organization/Agency*
DSHS License Number*
Agency Type*
Requestor Full Name*
Requestor Position/Title*
Requestor Phone*
Requestor Email*
Medical Director*
Medical Director Phone #*
Medical Director Email*
Should be Empty:

TEXAS EMS WRISTBAND PROJECT: WRISTBAND REQUEST