Change information on your EMS certification card or request a duplicate card

If you need to change the name on your EMT card, change your address, or request a duplicate card, follow these instructions.

Office of Emergency Medical Services

The Details of Change information on your EMS certification card or request a duplicate card

What you need for Change information on your EMS certification card or request a duplicate card

If you are requesting a name change for your EMT certification
  • Download the Name Change Request l (DOCX)
  • Provide court documentation to verify your name change, such as a marriage certificate or legal name change form
  • Fax or mail your Name Change form and official documentation. We cannot recommend emailing sensitive information such as Date of Birth.
If you are requesting a duplicate wallet card
  • Please submit your request below and please complete all sections.
  • Duplicate cards are free of charge
  • Cards are printed in batches once per week and mailed to the address of record
How to change your address
  • If you need to change the address that is listed on your card, you can do so online through the eLicensing portal

 

How to submit Change information on your EMS certification card or request a duplicate card

Mail your completed form and any necessary documents to:

Office of Emergency Medical Services
67 Forest Street
Marlborough, MA 01752

Fax your completed form and any necessary documents to (617) 753-7320 with the header "ATTN: EMS Certification"

Contact for Change information on your EMS certification card or request a duplicate card

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