Forms

Paramedic Forms (Applications, Credit Card Forms, etc.)
  • AUDIT Renewal Paramedic Application Packet [PDF]
  • Change of Address Form [PDF]
  • Course Log Sheet [PDF]
  • Credit Card Authorization Form [PDF]
  • Credit Card Authorization Form for Multiple Medics [PDF]
  • Detailed Disclosure Form [PDF]
  • Replacement Card Request [PDF]
  • Initial In-State (California Graduates) Paramedic License Application Packet [PDF]
  • Initial Out-of-State Paramedic Application Packet [PDF]
  • Initial Challenge Paramedic Application Packet – Physicians, RN’s, Physician Assistants, and MICN’s ONLY [PDF]
  • Instructions for Completing Fingerprint Cards [PDF]
  • Lapsed License Reinstatement Lapsed Less Than One Year Application Packet [PDF]
  • Lapsed License Reinstatement Lapsed One Year or More Application Packet [PDF]
  • License Verification Request Form #VL01 [PDF]
  • Live Scan Fingerprint Application Request form with instructions [Paramedics ONLY] [PDF]
  • Local EMS Agency (LEMSA) Paramedic Accreditation Report Form
  • Personal Information Update [PDF]
  • Renewal Paramedic Application Packet [PDF]

 

Training Program & CE Provider Forms (Applications, Credit Card Forms, etc.)