Emergency Medical Services to Community Paramedicine Referral Form

Streamline Emergency Care with Community Paramedicine Referrals

Emergency Medical Services (EMS) providers are increasingly recognizing that not every 911 call requires an emergency department visit. Community paramedicine programs offer a critical bridge between emergency response and ongoing healthcare management, helping to reduce unnecessary ED visits, lower healthcare costs, and improve patient outcomes through targeted interventions.

This Emergency Medical Services to Community Paramedicine Referral Form is specifically designed for EMS agencies, fire departments, ambulance services, and integrated healthcare systems implementing community paramedicine programs. Whether you're identifying super-utilizers, coordinating mobile health services, arranging alternative destination transport, or diverting patients from overcrowded emergency departments, this template provides a structured pathway for seamless care coordination.

Why Community Paramedicine Referrals Matter

Traditional emergency medical services operate on a "scoop and run" model—respond to the call, stabilize the patient, and transport to the nearest ED. But research shows that many frequent 911 callers have chronic conditions, social determinants of health issues, or behavioral health needs that are better addressed through community-based interventions rather than repeated emergency department visits.

Community paramedicine programs empower paramedics to:

• Identify super-utilizers who frequently access 911 services and would benefit from care coordination
• Provide mobile health services including medication reconciliation, wound care, and vital sign monitoring in patients' homes
• Coordinate alternative destination transport to urgent care clinics, behavioral health facilities, or sobering centers when appropriate
• Prevent unnecessary ED visits through on-scene treatment and referral to community resources

This referral form captures the critical information needed to transition patients from acute emergency care to ongoing community paramedicine support, ensuring continuity of care and appropriate resource allocation.

Who Benefits from This Template

EMS Agencies & Fire Departments: Field paramedics and EMTs can quickly document patient encounters that warrant community paramedicine follow-up, capturing utilization patterns, social needs, and clinical indicators that trigger referral pathways.

Community Paramedicine Programs: Program coordinators receive structured referrals with complete patient information, enabling them to prioritize high-risk patients, schedule follow-up visits, and coordinate with primary care providers and social services.

Integrated Healthcare Systems: Hospitals and health systems implementing ED diversion strategies can use this form to connect EMS providers with care management teams, reducing preventable admissions and improving population health outcomes.

Public Health Departments: Agencies overseeing mobile integrated healthcare programs benefit from standardized referral data that supports program evaluation, quality improvement, and funding justification.

Behavioral Health & Social Service Providers: Community partners receive timely referrals for patients with substance use disorders, mental health crises, or social determinants of health needs identified during emergency calls.

Key Features Built for Emergency Care Workflows

This template includes specialized fields for:

• Super-utilizer screening with frequency tracking and utilization patterns
• Clinical assessment data including vital signs, chief complaints, and medical history
• Social determinants of health screening for housing instability, food insecurity, and transportation barriers
• Alternative destination options for urgent care, crisis centers, and community clinics
• Consent documentation for follow-up services and information sharing
• Care coordination details for immediate needs and scheduled follow-up

The form uses conditional logic to adapt to different referral types—whether identifying a frequent caller for case management, arranging same-day mobile health services, or coordinating behavioral health crisis support.

Integrate Your Community Paramedicine Workflow

Paperform makes it easy to connect your referral process with existing healthcare systems. Send referrals directly to your electronic health record (EHR) system, notify care coordinators via email or SMS, and sync data with case management platforms. Using Stepper (stepper.io), you can automate the entire referral workflow—routing urgent cases to mobile health teams, scheduling follow-up visits, and tracking referral outcomes without manual data entry.

For agencies managing multiple jurisdictions or partner organizations, Paperform's Agency+ features let you customize the form for different service areas while maintaining consistent data collection standards.

Designed for Mobile Field Use

Field paramedics often work in challenging environments with limited time and connectivity. This form is optimized for mobile devices, allowing crews to complete referrals on tablets or smartphones during transport or immediately after patient contact. Offline-friendly embeds ensure that critical referral information isn't lost due to connectivity issues in remote or rural service areas.

Improving Outcomes Through Better Referrals

Community paramedicine programs report significant reductions in ED utilization, improved patient satisfaction, and cost savings when supported by systematic referral processes. By capturing the right information at the point of care, this form enables:

• Faster identification of patients who would benefit from community paramedicine
• More complete handoffs between emergency responders and care coordinators
• Better resource allocation by prioritizing high-risk and high-utilizer patients
• Measurable outcomes through consistent data collection for program evaluation

Whether you're launching a new community paramedicine initiative or optimizing an established mobile integrated healthcare program, this referral form provides the foundation for connecting emergency services with community-based care.

Secure, Compliant, and Trusted

Healthcare referrals require secure handling of protected health information. Paperform is SOC 2 Type II compliant with robust encryption, secure data handling, and access controls that meet healthcare industry standards. While not HIPAA compliant, Paperform provides enterprise-grade security suitable for many healthcare workflows where appropriate business associate agreements and additional safeguards are in place.

Trusted by healthcare providers, EMS agencies, and public health departments worldwide, Paperform delivers the reliability and security your community paramedicine program needs to succeed.

Transform your emergency medical services from reactive response to proactive care coordination. Start streamlining your community paramedicine referrals today with this comprehensive template designed specifically for the evolving needs of modern EMS and mobile integrated healthcare.