Instructions for report of basic emt continuing education - 2025

1. Click ‘Get Form’ to open the report of basic EMT continuing education in the editor.
2. Begin by filling out the registrant information section. Enter the date of your continuing education report, Indiana certification number, and driver's license/state ID number. Ensure all fields marked as required are completed.
3. Provide your provider affiliation, printed name, home address, and contact numbers. If applicable, indicate whether you have been trained in NIMS and specify the level of training.
4. Complete the violation statement by answering if you have ever been charged or convicted of any crimes other than minor traffic violations. If yes, provide details as required.
5. Sign and date the form where indicated for both the training officer and provider CEO if affiliated. Ensure that all signatures are original.
6. Fill out the continuing education hours section by listing each program attended along with dates, topics, instructor signatures, and total hours completed.

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