American College of Cardiology’s EMS Partner in Care

American College of Cardiology EMS Partner in Care Recognition Application

American College of Cardiology’s EMS Partner in Care Recognition is the ACC’s program recognizing EMS agencies who have a solid partnership with a Chest Pain Center Accredited Hospital or Chest Pain Center Certified Critical Access Hospital. Through this collaboration, EMS are seen as valued professional members of the care team. The facility and EMS partners have committed to ongoing communication and coordination efforts to improve patient outcomes and advance cardiac care in their communities.

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* 1. Hospital Information

Chest Pain Center Accredited or Certified Facility

Accreditation Account #

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* 2. EMS Agency Application

EMS Agency Name

DBA

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

NPI #

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* 3. EMS Key Contact

First Name

Last Name

Title

Email Address

Phone Number

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* 4. Additional EMS Contact

First Name

Last Name

Title

Email Address

Phone Number

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* 5. Type of service (Please choose one)

Private Ambulance

County or Municipal Fire

Volunteer Fire

County or Municipal EMS

Hospital Based EMS

Air Ambulance

Other (please specify)