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- Click ‘Get Form’ to open the EMT-Paramedic Recertification Form in the editor.
- Begin by filling in your EMT Number and Social Security Number. Ensure all information is printed neatly in UPPER CASE letters.
- Complete your personal details including Last Name, First Name, Address, City, State, and Zip Code.
- Enter the Agency Code of your Participating Agency accurately.
- Affirm your legal status regarding misdemeanors or felonies by checking the appropriate box and signing where indicated.
- Attach copies of your current CPR and ACLS certification cards (front and back) as required.
- Fill out the Skill Competency Verification section, ensuring that a Medical Director signs off on your skills.
- Complete the Continuing Education sections by listing topics and hours earned. Make sure totals meet requirements.
- Finally, sign and date the form along with the Sponsoring Agency Contact/Coordinator before submitting it at least 45 days prior to expiration.
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