Get the nys doh cli forms 2423

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Submit to the Bureau of EMS Central Office the following ORIGINAL documents A. This application form DOH-2260 with the following supporting documents B. The above named EMT/AEMT has actively provided on-going direct hands-on pre-hospital patient care with From Name of EMS Agency To Date Agency Code Signature of Chief Operations Officer or equivalent Supervisor Print Name of Chief Operations Officer or equivalent Supervisor DOH-2260 Rev. 03/12 p. ...
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nys doh cli forms 2423
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