Doh 3312-2026

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The document is a verification form from the New York State Department of Health for membership in a New York State Emergency Medical Services (EMS) agency. It requires applicants to provide personal information, agency details, and affirm their membership status. The form must be completed and returned to the course sponsor before course completion, with signatures from both the applicant and an official representative of the EMS agency.

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Click ‘Get Form’ to open the doh 3312 in the editor.
Begin by entering the Course Number at the top of the form. This number is essential for future reference.
Indicate whether this application is for Original Certification or Recertification by checking the appropriate box.
If you are recertifying, enter your NYS EMS Identification Number in the designated space.
Fill in your Last Name, First Name, and Middle Initial in capital letters as instructed.
If applicable, provide your Primary and Secondary EMS Agency codes in the boxes provided.
Enter the name of your Primary Agency and the official signing this form, including their last name, first name, middle initial, and agency title.
Read through the Personal Affirmation section carefully before signing. Ensure that both you and the agency official sign and date where indicated.

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How long is a NYS EMT certification valid?

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What does the doh do?

The New York State Department of Health (State DOH) protects, improves, and promotes the health, productivity, public safety, and wellbeing of all New Yorkers.

What does Doh stand for in a hospital?

The Department of Health (DOH) uses the definition of direct patient care for hospital staffing from the Centers for Disease Control and Prevention: Hands on, face-to-face contact with patients for the purpose of diagnosis, treatment, and monitoring. Further, state law (RCW 70.41.