- Name Change or Duplicate EMT Card Request
- Instructor and Examiner Applications
- Continuing Education
- Ambulance Services
- Service Zone Forms
- Training Institution Accreditation
- Updated Criminal Offender Record Information (CORI) Acknowledgment Form, 8/3/2012
(complete form and submit along with copy of government-issued photo ID, such as driver’s license or U.S. passport)
- A/R 2-248 Recertification Deadlines and Reinstatement Procedures for EMT-Basics Expiring 4/1/2015
- A/R 2-353 Recertification Deadlines and Reinstatement Procedures for Advanced EMTs and Paramedics Expiring 4/1/2015
- The following applications are for Reinstatement not Recertification. Recertification is now online, for instructions click here.
- EMT Continuing Education Training Program Application
- Forms 200-10, 200-11, 200-11a, EMT-BASIC Instructor/Coordinator Application Package
- Form 200-24, Basic Examiner Application, 9/2010
- Form 300-24, Advanced Examiner Application, 9/2010
- Medical Orders for Life-Sustaining Treatment (MOLST)
- Ambulance Regulation Program Plan of Correction
- Ambulance Services Division of Food and Drugs' Controlled Substance Registration Application
- Serious Incident Report Form
- Unprotected Exposure Form
- Ambulance Service License Application Instructions (see Parts A, B, C, D, E, F, and H)
- Complete Ambulance Service License Application (All Parts) file size 2MB
- Faxable Complaint Reporting Form
- A/R 5-510: Priority of Recognition of Local Jurisdictions for Service Zone Planning
- Current List of Local Jurisdictions with Department-approved EMS Service Zone Plans - 9/17/2014
- Current Service Zone Plan Application file size 1MB
- Original Service Zone Application, Cover Letter to Chief Municipal Officers
- Response Times and Service Zone Planning
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