Form Rural EMS Monitori Rural EMS Monitori Rural EMS Monitoring Report

Rural EMS Training Program Monitoring Report

Rural EMS Training Grant number: _____________________

Rural EMS Training Organization name: __________________________________

Progress Report period: __________________ to _________________

MM/DD/YYYY MM/DD/YYYY

Please provide the following information for the current progress performance period (6 months):

1. The number of EMS personnel recruited:

2. The number of EMS personnel enrolled in training:

3. The number of EMS personnel who became licensed/certified as a result of funding support in this grant program:

4. The number of courses offered/conducted that qualify graduates to serve in an EMS agency:

5. The number of courses on mental and substance use disorders offered as a result of this funding:

6. The number of specific trainings funded out of this grant to meet Federal or State licensing or certification requirements:

7. The number of technology-enhanced educational methods developed to educate EMS providers:

8. List of emergency medical equipment or supplies purchased with the grant funds: