Forms

Cancer Coverage

  1. Cancer Coverage - Annual Roster Report Form 210.8R
  2. Cancer Coverage - Claims Report Form 210.8C
  3. Cancer Coverage - Eligibility Insurance Form Form 210.4
  4. Cancer Coverage - Enhanced Cancer Benefit Program Overview
  5. Cancer Coverage - Proof of Benefits Form 210.5
  6. Cancer Coverage - Student Data Sheet

Workplace Health and Injury Forms

  1. Light Duty Opportunities for Volunteer Firefighter and EMS Workers
  2. New York State Workers Compensation C-2 Form
  3. New York State Workers Compensation C-2 Form Instructions
  4. Workers Compensation Information Letter
  5. Workplace Health Firefighter Physicals Information
  6. Workplace Health Services Annual Respiratory / Fire Questionnaire
  7. Workplace Health Services Requisition for Medical Services for Emergency Response Personnel
  8. Wyoming County Incident Report

Training Authorization Forms

  1. EMS Training Form
  2. Training Authorization Form (4/22)

Miscellaneous Forms

  1. Application for Firefighter Background / Arson Check
  2. Application for Use of Wyoming County Fire Training Center
  3. Communications Trouble Report
  4. DMV Driving Record Request
  5. Fire Advisory Board Mutual Aid Report
  6. Fire Departments Location Codes
  7. FIT Testing Request
  8. FIT Testing Roster Form
  9. Flagged Addresses Request Form
  10. IT-245 Credit Form
  11. New York State Office of Fire Prevention and Control Student Data Sheet - Form EOSB-601
  12. New York State Training ID Request
  13. Procedures for Volunteer Firefighter Background Check
  14. Volunteer Firefighter Inquiry Form for Background Check
  15. Wyoming County Building Codes Fire Notification Form
  16. Wyoming County Discovery Incident Responder List
  17. Wyoming County Discovery Incident Roster
  18. Wyoming County Fire Training Center Burn Tower SOG's
  19. Attachment 2 - Assigned Emergency Services Observer Briefing Checklist
  20. Wyoming County Emergency Response Team Application
  21. Wyoming County Fire EMS Interest Form
  22. Wyoming County ID Request Form

NYSDOH CME Forms

  1. CME Cover Sheet
  2. CME Recert Manual
  3. DOH 4231
  4. DOH 5065
  5. DOH 5066
  6. DOH 5067
  7. DOH 5295