Transcription of Initial EMS Certification Application Packet
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Initial EMS Certification Application Packet
EMS Certification Application PacketContents: 1. 530-060 ..Contents List/SSN Information/ Mailing Information ..1 page2. 530-061 .. Application Instructions pages2. 530-191 .. Certification Requirements ..2 pages3. 530-015 ..EMS Certification Application ..4 pages4. 530-117 ..General Instructions Checklist and EMS Supervisor/Medical Program Director Signature Form ..2 pages5. 530-065 ..Out-of-State Credential Verification Form ..1 page6. RCW/WAC and Online Website pageImportant Social Security Number Information:If you have a Social Security Number, the law requires you to disclose it on your Application for a professional or occupational license.
Provide your national registry number and the date that you took and passed the National Registry of Emergency Medical Technicians (NREMT) examination. F 6. Other License, Certification, or Registration: List all states, including Washington, where health care provider credentials are or were held.
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