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Return to Clinical Practice
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Return to clinical Practice
RTCP Form (Service Manager)
Please complete all required fields!
Please complete this form to submit a Return to Clinical Practice on behalf of a paramedic. Once submitted, an RPPEO staff member will be in contact with you to follow up with a plan.
Paramedic Name
(*)
Please enter paramedic's name.
EHSN
EHSN is a five digits number.
RSOP
None
ACP-3
ACP-2
PCP
EMA-SR
EMA-SAED
Invalid Input
Last Date of Clinical Activity
(*)
...
Please enter a date yyyy-mm-dd.
Expected Return to Clinical Activity
(*)
...
Please enter a date yyyy-mm-dd.
Describe your service RTCP plan for this paramedic
(*)
Please provide the detail of your request.
Name of person submitting
(*)
Please enter your full name.
Email
(*)
Please enter a valid email address.
Submit
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