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How to use or fill out PDF EMS Certificate/Wallet Card Replacement Form
- Click ‘Get Form’ to open it in the editor.
- Begin with Section 1 – Personnel Data. Fill in your last name, first name, and middle name. Ensure you type or print in black ink for clarity.
- Select your EMS role from the options provided, such as EMT or Licensed Paramedic. If applicable, indicate if you are enclosing a $10 fee.
- Complete your contact information including address, city, county, state, zip code, telephone number, and email address.
- If claiming fee exemption, proceed to Section 2 – Volunteer Sign-Off. Have an approved EMS Provider or FRO administrator complete this section.
- In Section 3 – Signature and Date, affirm that all information is accurate by signing and dating the form.
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