EMS Certification Application
EMT Certification Checklist(PDF, 45KB)
EMT Skills Competency Verification Form and Instructions(PDF, 51KB)
Live Scan Form(PDF, 438KB)

Skills Verification Performance Checklists


Medical Transportation Information Log(PDF, 9KB)

Quality Assurance

Quality Improvement Report(PDF, 86KB)

Quality Improvement Tracking Report(PDF, 180KB)


CE Provider Disclosure Form(PDF, 46KB)
Continuing Education Roster(PDF, 21KB)
Field Internship Logs and Evaluation Forms(PDF, 1021KB)
Field Internship - Major Evaluation Form(PDF, 254KB)
Field Internship - Daily Performance Evaluation Form(PDF, 290KB)

Automatic External Defibrillators

Notification of New Public Access Defibrillator Site(PDF, 79KB)

Notification of Defibrillator Use(PDF, 39KB)

Reporting Forms

CCEMSA Naloxone Reporting Form for First Responders(PDF, 334KB)