Providence Ambulance eOrders – Ambulance Transport Order Portal

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Entry ID	208
eOrder Submission Date	02/10/2026
eOrder Submission Time	10:39 AM
Requester Information
Ordering Facility	Providence Saint John's Health Center Santa Monica
Title	Other
Other Title	Dean
Requester Department	Comm
Requester Phone	3106440500
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	02/10/2026
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	123
Pickup Location Patient Room/Bed No.	1
Pickup Location Department Phone	3106440500
Pickup Location Contact Name	jsj jsjsj
Drop Off Location Information
Drop Off Location	Providence St. Joseph Hospital - Orange Center for Cancer Prevention and Treatment
Drop Off Receiving Department/Unit Name	ssas
Drop Off Receiving Department Phone	3106440500
Reimbursement Information
Patient Information
Patient Name	test test
Medical Record No.	123
Patient Sex	Male
Patient Date of Birth	02/01/2018
Patient Age	6
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	02/10/2026