Anchorage Middletown Fire & EMS, Jefferson County Kentucky
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  • Home
  • News
  • Contact Us / Stations
  • "I Want To..."
    • Birthday Party at Firehouse
    • EMS Records
    • EMS Patient Forms
    • Fire Extinguisher Training
    • A Fire Incident Report
    • A Fire Truck in our Parade
    • A Home Safety Visit
    • Public Education
    • Smoke/CO Alarm Assistance
    • To Use a Room at Fire Station
    • To Visit a Fire Station
  • After a fire
  • Employment
    • Fire Recruit Class
    • Employment Verification
  • Code Enforcement
  • FAQ - Questions
  • Fire/EMS Vehicles
  • Fire Marshal
  • Fire Safety / Risk Reduction
  • Open Records
  • Personnel
    • Contacts
    • Leadership
    • Trustees
    • Divisions
    • Chaplain
  • Peer & Family Support
  • Public Information
Anchorage Middletown Fire and EMS
​​
​108 Urton Lane Louisville, KY 40223
(502) 245-7555

EMS Forms & Compliance


Kentucky MOST Form

The Medical Order for Scope of Treatment (MOST) form is a voluntary end-of-life planning tool designed to give those who are seriously ill or medically frail the opportunity to make their health care wishes known in the event they are unable to speak for themselves. The MOST form can be completed by a patient or their health care surrogate and must be signed by a doctor.

​Additional information can be found at www.kymost.org
KY MOST FORM

Kentucky EMS Do Not Resuscitate (DNR) Form

Kentucky law forbids the EMS from recognizing any DNR request unless it's specifically spelled out on the "Kentucky Emergency Medical Services Do Not Resuscitate (DNR) Order". Furthermore, the original form should be accessible by EMS when arriving on the scene. If you do not wish for EMS to resuscitate a patient, please download the Kentucky State DNR form and fill it out following the supplied instructions. Without this form, we will have to do everything in our power to keep the patient alive. Keep in mind that this form is only applicable if you stop breathing or your heart stops beating.
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It's also important to note that you must present EMS with the original, signed document—not a copy. (We suggest you make several originals so all concerned parties will have an actionable form).
​

If you need help filling out the form, we will be glad to assist you. Or if you don't have anyway to print out the document, contact us and we will have one sent to your home.
Kentucky DNR (English)
KY DNR Eng
Kentucky DNR (Spanish)
KY DNR ESP

EMS Compliance

KRS 311A.190 authorizes the Kentucky Board of Emergency Medical Services to promulgate administrative regulations concerning EMS information that ambulance services shall furnish to the board and authorizes the Kentucky Board of Emergency Medical Services to require collection and submission of EMS data that will allow for analysis of the state's needs for provision of EMS and that will allow the state to participate in the National Emergency Medical Services Information System (NEMSIS), a multi-partnered project that is funded by the National Highway Traffic Safety Administration, the Health Resources and Services Administration, the Centers for Disease Control and Prevention, the Federal Emergency Management Administration, and HRSA's Office of Rural Health Policy. This administrative regulation establishes standards and criteria for data collection, submission, and compliance.
EMS Billing Rates
Billing Rates
Training and Educational Institution Authorization
AMFEMS TEI Cert
Notice of Privacy Practices
AMFEMS HIPPA NPP
2023 KBEMS Agency License Certificate
2023 CERT
©2023 ANCHORAGE MIDDLETOWN FIRE AND EMS
HEADQUARTERS - ​​108 URTON LANE
LOUISVILLE, KY 40223
502-245-7555
TwinSprings
  • Home
  • News
  • Contact Us / Stations
  • "I Want To..."
    • Birthday Party at Firehouse
    • EMS Records
    • EMS Patient Forms
    • Fire Extinguisher Training
    • A Fire Incident Report
    • A Fire Truck in our Parade
    • A Home Safety Visit
    • Public Education
    • Smoke/CO Alarm Assistance
    • To Use a Room at Fire Station
    • To Visit a Fire Station
  • After a fire
  • Employment
    • Fire Recruit Class
    • Employment Verification
  • Code Enforcement
  • FAQ - Questions
  • Fire/EMS Vehicles
  • Fire Marshal
  • Fire Safety / Risk Reduction
  • Open Records
  • Personnel
    • Contacts
    • Leadership
    • Trustees
    • Divisions
    • Chaplain
  • Peer & Family Support
  • Public Information