TABLE 9: FACILITIES ________________________________________________ County: Note: Complete information for each facility by county. Make copies as needed. Facility: Telephone Number: Address: Written Contract: Service: Base Hospital: Burn Center: Yes No Referral Emergency Standby Emergency Yes No Yes No Basic Emergency Comprehensive Emergency Pediatric Critical Care Center Yes No Trauma Center: If Trauma Center what level: EDAP Yes No PICU Yes No Yes No Level I Level II Level III Level IV STEMI Center: Stroke Center: Yes No Yes No
TABLE 9: FACILITIES County: ________________________________________________ Note: Complete information for each facility by county. Make copies as needed. Facility: Telephone Number: Address: Written Contract: Yes No Service: Referral Emergency Standby Emergency Basic Emergency Comprehensive Emergency Base Hospital: Yes No Burn Center: Yes No Pediatric Critical Care Center Yes No EDAP Yes No PICU Yes No Trauma Center: Yes No If Trauma Center what level: Level I Level II Level III Level IV STEMI Center: Yes No Stroke Center: Yes No
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