Important Documents

Certification Packages

The following certification packages contain the downloadable printable forms and information required for certifying. However, be sure to fill out the online application online application HERE for speedy processing, convenience, and save a tree. You should still download the applicable package and print any supporting documentation you need. You may scan and submit the documentation online or you may mail the supporting documentation in. If you have certified with Nor-Cal before, most of your information will already be filled in for you in the Online Application for Certification

EMR Certification Packages

• Emergency Medical Responder Initial Certification Application Package
  
  This is the complete application package for Emergency Medical Responder Initial Certification and includes all applicable forms necessary for certification.
  
  
• Emergency Medical Responder Recertification Application Package
  
  This is the complete application package for EMR Recertification and includes all applicable forms necessary to recertify.

EMT Certification Packages

• EMT Initial Certification Package for Emergency Medical Technician
  
  This is the complete application package for EMT Initial Certification and includes all applicable forms necessary for certification as well as the DOJ Live Scan application.
  
  
• EMT Recertification Package for Emergency Medical Technician
  
  This is the complete application package for EMT Recertification and includes all applicable forms necessary to recertify as well as the DOJ Live Scan application if required.

AEMT Certification Packages

• AEMT Initial Certification Package for Advanced Emergency Medical Technician
  
  This is the complete application package for AEMT Initial Certification and includes all applicable forms necessary for certification as well as the DOJ Live Scan application.
  
  
• AEMT Recertification Package for Advanced Emergency Medical Technician
  
  This is the complete application package for AEMT Recertification and includes all applicable forms necessary to recertify as well as the DOJ Live Scan application if required.

MICN Authorization Packages

• MICN Initial Authorization Package
  
  This is the complete application package for MICN Initial Authorization and includes all applicable forms necessary for authorization.
  
  
• MICN Reauthorization Package
  
  This is the complete application package for MICN Reauthorization and includes all applicable forms necessary to be reauthorized.

Paramedics Accreditation Packages

• Paramedic Initial Accreditation Package
  
  This is the complete application package for Paramedic Initial Accreditation and includes all applicable forms necessary for your initial accreditation.
  
  
• Paramedic Continuous Accreditation Package
  
  This is the complete application package for Paramedic Continuous Accreditation and includes all applicable forms.

General Forms

• ORDER SUPPLY FORM
• Change of Address
• Exemplary Performance Nomination Form
• EMS and Non-Emergent (Medical) Transport Organizations Pandemic Influenza Planning Checklist
• EMS Standard Barrier and Droplet Precautions for ILI
• 101D - Skills and Medication Usage Form
• ALS Skills Competency Check Off
• 102C Interim Patient Report
• 104 Unusual Occurence Report
• 303B EMT Skills Competency Verification Form
• 402A Confidential Investigation Report
• Probation Quarterly Reports
• Request for Provider Agreement/Application

Reference

• Interfacility Transports Regulation Reference Sheet

Miscellaneous

• Criminal History
• Employment History
• Background Questionnaire

Document Archive

Great information that shouldn't ever get lost.

Here you will find documents that have been made available on our web site at one time or another for a specific reason. Once the specific purpose the document was posted has passed, the document is moved here if it contains useful information that should still be made available As the list grows, we will figure out a way to keep this information organized and useful.

• Important Flu Information for EMS Responders