Application for Tertiary Trauma Hospital (TTH), Regional Trauma Hospital (RTH), or Area Trauma Hospital (ATH)

Date:

Name and title of person completing the application: *

Facility Informaton

Facility: *

Address: *

City: *

State: *

Zip Code: *

Type and Level of Designation

Type of Designation: *

Initial Designation
Re-designation

Level of Application: *

Tertiary Trauma Hospital ACS I
Regional Trauma Hospital ACS II
Area Trauma Hospital ACS III

Trauma Coordinator Information

Name of Trauma Coordinator: *

Phone Number: *

Email Address: *

Content last updated: April 30, 2024. For questions, contact:

Jamie Zilverberg
Trauma Program Manager & Eastern EMS Specialist
600 East Capitol Avenue
Pierre, SD 57501

email: Jamie.Zilverberg@state.sd.us
local: 605-773-3308
fax: 605-773-5683

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