CAL-MAT Registration Process for Persons Not Currently or Formerly

Affiliated With a Federal Disaster Medical Assistance Team (DMAT) in

California (Phase II)

Persons interested in participating in the California Medical Assistance Team (CAL-MAT) Program must follow the following steps to apply for consideration of acceptance:

 

1. Meet Eligibility Requirements:

• 18 Years of age and over

• Eligible to work in the United States

• No felony background

• Valid California License for clinical practice.

• No negative license/certification actions (for licensed/certified professionals)

 

2. Be Recommended By A Current CAL-MAT Unit Leader

 

3. Register in the Disaster Healthcare Volunteer (DHV) Program

Registration in DHV is required. Specific instructions for CAL-MAT Phase II are found here:

https://emsa.ca.gov/wp-content/uploads/sites/71/2018/08/DHV-Registration-for-CAL-MAT-Program-Phase-II.pdf

 

4. Complete and Submit Necessary State Hiring Application and Related Forms

Complete, print and sign in BLUE INK the following documents:

a. State Standard Employment Application (Form 678): https://jobs.ca.gov/pdf/std678.pdf

  • One form is used for all positions you may be interested in filling on a CAL-MAT. Make sure that you adequately document work experience and education to justify all positions applied for.
  • DO NOT include complete Social Security Number on the application.
  • Include hardcopy of all licenses/certifications

b. Eligibility to Work I – 9 Form:

https://emsa.ca.gov/wp-content/uploads/sites/71/2018/03/i-9-fillable-form-11-16.pdf

Complete Section 1 only. EMSA will complete Section 2.

Submit adequate documentation for eligibility verification (see page 3).

c. Oath of Allegiance:

https://emsa.ca.gov/wp-content/uploads/sites/71/2018/03/11.-Oath-of-Allegiance-std689.pdf

State Department: EMSA      Division: DMS

d. Military Service Declaration

https://emsa.ca.gov/wp-content/uploads/sites/71/2018/03/12.-Military-Service-Declaration-std912.pdf

You must submit this form even if you do not have military service. (Check No on question 1).

e. State Employee Race/Ethnicity Questionnaire:

https://emsa.ca.gov/wp-content/uploads/sites/47/2017/10/State-Employee-Race-Ethnicity-Questionnaire.pdf

f. Employer Authorization:

https://emsa.ca.gov/wp-content/uploads/sites/47/2017/10/Information-for-Employers.pdf

Mail completed and signed documents, along with verification of education, licenses, work eligibility, etc., in an envelope marked CONFIDENTIAL to:

 

California Emergency Medical Services Authority

10901 Gold Center Dr. 4th Floor

Rancho Cordova, Ca.  95670

Attention: Human Resources