{"id":2114,"date":"2020-11-18T07:28:51","date_gmt":"2020-11-18T07:28:51","guid":{"rendered":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/?page_id=2114"},"modified":"2021-02-03T13:42:19","modified_gmt":"2021-02-03T21:42:19","slug":"forms","status":"publish","type":"page","link":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/forms\/","title":{"rendered":"Forms"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column][vc_column_text]<a href=\"https:\/\/file.lacounty.gov\/dhs\/cms1_207119.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Patient Transfer Request Form<\/a><br \/>\n<a href=\"https:\/\/file.lacounty.gov\/SDSInter\/dhs\/1077960_Transfer-EMTALAForm.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">L.A. County Hospital Problem Transfer Report Form<\/a><br \/>\n<a href=\"https:\/\/file.lacounty.gov\/dhs\/cms1_206942.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Impacted Hospital Program (IHP) Enrollment Form<\/a><br \/>\n<a href=\"https:\/\/file.lacounty.gov\/dhs\/cms1_206941.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Verification of Residency for Impacted Hospital Program<br \/>\n<\/a><a href=\"https:\/\/file.lacounty.gov\/dhs\/cms1_224634.pdf\">Verification of Residency for Patients Presenting As Homeless<\/a><\/p>\n<p>&nbsp;<\/p>\n<p><em><strong>LA County Surge Hospitals Transfer Packet<\/strong><\/em><\/p>\n<ul>\n<li><a href=\"https:\/\/file.lacounty.gov\/SDSInter\/dhs\/1102283_SURGEHOSPITALADMISSIONPACKET.pdf\">Surge Hospital Transfer Request Packet<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_column_text]Patient Transfer Request Form L.A. County Hospital Problem Transfer Report Form Impacted Hospital Program (IHP) Enrollment Form Verification of Residency for Impacted Hospital Program Verification of Residency for Patients Presenting As Homeless &nbsp; LA County Surge Hospitals Transfer Packet Surge Hospital Transfer Request Packet [\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":1999,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/template-subsite-basic-page.php","meta":{"_oasis_is_in_workflow":0,"_oasis_original":0,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[],"tags":[],"class_list":["post-2114","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Forms - Emergency Medical Services Agency<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/forms\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Forms - Emergency Medical Services Agency\" \/>\n<meta property=\"og:description\" content=\"[vc_row][vc_column][vc_column_text]Patient Transfer Request Form L.A. County Hospital Problem Transfer Report Form Impacted Hospital Program (IHP) Enrollment Form Verification of Residency for Impacted Hospital Program Verification of Residency for Patients Presenting As Homeless &nbsp; LA County Surge Hospitals Transfer Packet Surge Hospital Transfer Request Packet [\/vc_column_text][\/vc_column][\/vc_row]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/forms\/\" \/>\n<meta property=\"og:site_name\" content=\"Emergency Medical Services Agency\" \/>\n<meta property=\"article:modified_time\" content=\"2021-02-03T21:42:19+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/home\\\/medical-alert-center\\\/forms\\\/\",\"url\":\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/home\\\/medical-alert-center\\\/forms\\\/\",\"name\":\"Forms - Emergency Medical Services Agency\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/#website\"},\"datePublished\":\"2020-11-18T07:28:51+00:00\",\"dateModified\":\"2021-02-03T21:42:19+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/home\\\/medical-alert-center\\\/forms\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/home\\\/medical-alert-center\\\/forms\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/home\\\/medical-alert-center\\\/forms\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Emergency Medical Services (EMS) Agency\",\"item\":\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Medical Alert Center (MAC)\",\"item\":\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/home\\\/medical-alert-center\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Forms\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/#website\",\"url\":\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/\",\"name\":\"Emergency Medical Services Agency\",\"description\":\"Just another Network site\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/dhs.lacounty.gov\\\/emergency-medical-services-agency\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Forms - Emergency Medical Services Agency","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/forms\/","og_locale":"en_US","og_type":"article","og_title":"Forms - Emergency Medical Services Agency","og_description":"[vc_row][vc_column][vc_column_text]Patient Transfer Request Form L.A. County Hospital Problem Transfer Report Form Impacted Hospital Program (IHP) Enrollment Form Verification of Residency for Impacted Hospital Program Verification of Residency for Patients Presenting As Homeless &nbsp; LA County Surge Hospitals Transfer Packet Surge Hospital Transfer Request Packet [\/vc_column_text][\/vc_column][\/vc_row]","og_url":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/forms\/","og_site_name":"Emergency Medical Services Agency","article_modified_time":"2021-02-03T21:42:19+00:00","twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/forms\/","url":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/forms\/","name":"Forms - Emergency Medical Services Agency","isPartOf":{"@id":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/#website"},"datePublished":"2020-11-18T07:28:51+00:00","dateModified":"2021-02-03T21:42:19+00:00","breadcrumb":{"@id":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/forms\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/forms\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/forms\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Emergency Medical Services (EMS) Agency","item":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/"},{"@type":"ListItem","position":2,"name":"Medical Alert Center (MAC)","item":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/home\/medical-alert-center\/"},{"@type":"ListItem","position":3,"name":"Forms"}]},{"@type":"WebSite","@id":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/#website","url":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/","name":"Emergency Medical Services Agency","description":"Just another Network site","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/wp-json\/wp\/v2\/pages\/2114","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/wp-json\/wp\/v2\/comments?post=2114"}],"version-history":[{"count":0,"href":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/wp-json\/wp\/v2\/pages\/2114\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/wp-json\/wp\/v2\/pages\/1999"}],"wp:attachment":[{"href":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/wp-json\/wp\/v2\/media?parent=2114"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/wp-json\/wp\/v2\/categories?post=2114"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dhs.lacounty.gov\/emergency-medical-services-agency\/wp-json\/wp\/v2\/tags?post=2114"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}