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Texas ems form 2026

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The document is an Emergency Medical Services Provider License Declaration Form, revised on February 16, 2018. It outlines the application process for obtaining or renewing a license to operate as an emergency medical services provider in Texas. The form requires detailed information about the legal entity, including contact details, vehicle authorizations, compliance with regulations, and attestation of qualifications. It also includes sections for various administrative contacts and necessary documentation related to insurance and operational capabilities.

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Click ‘Get Form’ to open the Texas EMS Provider License Declaration Form in the editor.
Begin by selecting the application type: Initial Application, Renewal Application, or Other. Fill in your DSHS License Number if applicable.
In Section 1, enter the Legal Entity Name. Proceed to Section 2 to list any Assumed or Operating Names, attaching certificates if necessary.
Complete Sections 4 through 8 by providing details for the Chief Executive Officer, Administrator of Record, Alternate Contact, and Physician Medical Director respectively.
In Section 9, specify the number of vehicle authorizations requested at each level. Ensure all required fields are filled accurately.
Continue through Sections 10 to 15, checking appropriate boxes and providing necessary information about your entity type, insurance, and signatures.

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Versions	Form popularity	Fillable & printable
2018	4.9 Satisfied (52 Votes)
2017	4.3 Satisfied (48 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can a Canadian paramedic work in the USA?

Paramedic licensure in the US is state based. Generally paramedics with foreign credentials must pass the appropriate National Registry of Emergency Medical Technicians exam as a first step, followed by any applicable state requirements.

Can a foreigner become a paramedic in the US?

Citizens and nationals of the United States who meet all eligibility requirements may receive paramedic licensure and must fill out Sections A and D. Aliens who meet all eligibility requirements may also receive paramedic licensure and must complete SECTIONS A, B or C, and D of this form.

How often do EMS personnel have to take and pass a jurisprudence examination?

Recertification requirements All newly certified applicants and re-certification applicants are required to take a state approved jurisprudence exam each time a certification is up for renewal.

How to get Texas EMS certification?

Requirements You must be at least 18 years old. Have a high school diploma or GED certificate. Successfully complete a DSHS approved EMS training course. Submit a completed EMS Personnel Certification application and fee. Pass the National Registry exam. Submit fingerprints for Texas/FBI criminal history check.

Can a Canadian paramedic work in Texas?

An out-of-state certified emergency medical services (EMS) person may apply for Texas certification by reciprocity.

texas ems license verification

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What are the levels of EMS in Texas?

Texas has five levels of certification. The highest is Licensed Paramedic, followed by EMT Paramedic, Advanced EMT, EMT Basic, and Emergency Care Attendant (ECA).

How to get Texas paramedic reciprocity?

Requirements Must be at least 18 years old and have a high school diploma or GED. Must either have a current Out of State certification or current National Registry certification. Submit an online reciprocity application and pay the non-refundable application fee.