Providence Ambulance eOrders – Ambulance Transport Order Portal

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Entry ID	207
eOrder Submission Date	01/30/2026
eOrder Submission Time	12:40 PM
Requester Information
Ordering Facility	Providence St. Joseph Hospital Orange
Title	Other
Other Title	Test
Requester Department	Test
Requester Phone	13107025409
Requester Email	Email hidden; Javascript is required.
Service Needs Information
Service Level	EMT Basic Life Support
Trip Type	One-Way
Bariatric Patient?	No
Ambulance Transfer Reason(s)	In-patient inter-campus transfer.
Trip Schedule Information
Pickup Date	01/30/2026
Response Type	Next Available - Patient Ready Now
Standing Order	No
Pickup Location Information
Pickup Location	Providence St. Josseph Hospital Orange
Pickup Location Department/Unit Name	test
Pickup Location Patient Room/Bed No.	test
Pickup Location Department Phone	13107025409
Pickup Location Contact Name	Joseph Diaz
Drop Off Location Information
Drop Off Location	Providence St. Josseph Hospital Orange
Drop Off Receiving Department/Unit Name	test
Drop Off Patient Room/Bed No.	test
Drop Off Receiving Department Phone	13107025409
Drop Off Receiving Contact Name	test test
Reimbursement Information
Patient Information
Patient Name	test test test
Medical Record No.	test
Patient Sex	Male
Patient Date of Birth	04/05/1981
Patient Age	44
Spoken Language	English
Interpreter Required?	No
Patient Medical Information
Isolation Precaution	No
Medical Necessity Certification
Is Patient Bed-confined?	Yes
Medical Needs During Transport
Required Equipment and Care	Airway Monitoring
Accompanying Documents	Please upload accompanying transfer documents.
Order Submission Certification
Signature
eOrder Submission Date	01/30/2026