PDF
Word
Form SFN52195 EMS Course Roster / Physician Authorization - North Dakota
What Is Form SFN52195?
This is a legal form that was released by the North Dakota Department of Health and Human Services - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form SFN52195?
A: Form SFN52195 is the EMS Course Roster/Physician Authorization form.
Q: What is the purpose of Form SFN52195?
A: Form SFN52195 is used to document the roster of participants in an EMS course and to authorize the course by a physician.
Q: Who uses Form SFN52195?
A: EMS providers and course coordinators in North Dakota use Form SFN52195.
Q: What information is required on Form SFN52195?
A: Form SFN52195 requires information such as the course number, date, location, participants' names, addresses, and physician authorization.
Q: Is Form SFN52195 specific to North Dakota?
A: Yes, Form SFN52195 is specific to EMS courses in North Dakota.
Form Details:
- Released on December 1, 2020;
- The latest edition provided by the North Dakota Department of Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form SFN52195 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Health and Human Services.
