Nys doh 5065-2026

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The document is an EMT Recertification Form from the New York State Department of Health, requiring emergency medical technicians to provide personal information, affirm their legal status, and document their continuing education hours. It outlines the necessary training hours across various medical topics, CPR certification requirements, and skill competency verification by a Medical Director or Training Officer. The form emphasizes the importance of accuracy in submissions and includes signatures for validation.

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Click ‘Get Form’ to open the NYS DOH 5065 in our platform.
Begin by filling in your EMT Number and Social Security Number. Ensure that you print neatly in UPPER CASE letters as required.
Complete your personal information, including Last Name, First Name, Address, City, State, and Zip Code.
Enter the Agency Code of your participating agency. This is crucial for processing your recertification.
Affirm your legal status regarding misdemeanors or felonies by signing and dating the affirmation section.
Document your completed EMT Refresher Training hours in the designated section. Make sure to total them accurately.
Attach a copy of your current CPR certification card (front and back) as instructed.
Fill out the Skill Competency Verification section, ensuring that both the Medical Director/Training Officer signs it.
Finally, affirm that all statements are true by signing and dating at the bottom of the form before mailing it postmarked no less than 45 days prior to expiration.

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How long does it take to be an EMT in NY?

The EMT course is 208 hours over a 2-4 month period, depending on the schedule.

Does NJ accept NREMT?

New Jersey is using NREMT certification as the entry-level requirement, with re- certification maintained through continuing education. EMTs may, but do not have to, maintain both NREMT certification and their NJ EMT license.

How do I become a certified EMT in NY?

New York Education and Certification Requirements To be a certified as an EMT or AEMT, you must be 18 by the end of the month the exam is taken. Formal training and certification is required through course sponsors approved by NYSDOH. More advanced types of EMTs, namely paramedics, complete more training.

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