TCEMCA Forms

Authorization forms get submitted to: authorizations@tcemca.org

Pharmacy Accountability or Reporting forms get submitted to: pharmacy@tcemca.org

Patient Outcome Request and Concerns forms get submitted to: melissa.chamberlain@tcemca.org

Inability to Provide Service and Agency Directors Rep. forms get submitted to: bill.priese@tcemca.org

American CME – TCEMCA Authorization Test Link

Provider Authorization/Skills Sheet

Patient Outcome Request

Agency Directors Committee Representation Form

Concerns Form

Pharmacy Accountability – Complete Set

Pharmacy Accountability – Epinephrine Inventory Only

Pharmacy Accountability – BLS Red Bag Inventory Only

Pharmacy Accountability – Narcan Inventory Only

Agency Inability to Provide Service Form

Pharmacy Reporting Form