- All applicants must use this secure online application form.
- All certifications and licenses can take up to 10 days to process.
- Please turn in all recertification required materials at least 10 days before the expiration date.
- You will receive a notice of completed processing verifying your certification/license is valid and active within 10 days.
- If your certification/license expires, patient contact is strictly prohibited from the time of expiration to the time of verified processing.
Required documentation (front and back of cards) for each certification is listed. You will need to attach all items in order to submit the application. Uploads can be images, pdf, or doc. Payment due at time of submission. Page will not save any uploads or entries if page is refreshed or left. All fees listed include $2 processing fee.
*Reasons the form does not allow you to process/error pops up: Logging onto internet from work or work computer restrictions, personal settings/restrictions, WiFi connection, internet connection (weather). It is also possible to recert by phone, attaching photos and processing payment. If all attempts fail, please contact Kathy in the office to find out how to submit.
EMR
- Copy of current gov. issued ID
- Copy of current CPR card(AHA or equivalent)
- Copy of EMR Course Completion Certificate
- Copy of processed “Request for Live Scan(DOJ)”
- Fee of $37 at time of submission
- Copy of current gov. issued ID
- Copy of current EMR card
- Copy of EMR Skills Competency Verification Form
- Copy EMR Continuing Education Log or EMR refresher course cert. (12 hrs.)
- Fee of $30 at time of submission
Additional if lapsed
(Initial app required if lapsed more than 12 months):
Fee $37
<6mo: fee no other changes
>6mo but <12mo: 24 total CEs required
EMT
- Copy of current gov. issued ID
- Copy of current CPR card(AHA or equivalent)
- Copy of EMT Course Completion Certificate
- Copy of National Registry EMT Certification Card
- Copy of processed “Request for Live Scan(DOJ)”
- Fee of $122 at time of submission
- Copy of current EMT card
- Copy of EMT Skills Competence Verification Form
- Copy of current gov. issued ID
- Copy EMT Continuing Education Log or EMT refresher course cert. (24 hrs.)
- Fee of $67 at time of submission
Additional Items if lapsed:
Fee $84
<6mo: no other changes
>6mo but <12mo: 36 total CEs required
Additional if Lapsed more than 1 year:
>12Mo: 48 Total CEs required, valid NREMT card, Live Scan (unless current AEMT or Paramedic), $122
AEMT
- Copy of current gov. issued ID
- Copy of current CPR card(AHA or equivalent)
- Copy of Current EMT Card issued in CA (if applicable)
- Copy of Current AEMT certification card is issued out of state or Copy of AEMT Course Completion Certificate
- Copy of National Registry AEMT Certification Card
- Copy of processed “Request for LiveScan(DOJ)”
- Fee of $122 at time of submission
- Copy of current gov. issued ID
- Copy of current AEMT card
- Copy of AEMT Skills Competency Verification Form
- Copy AEMT Continuing Education Log (36 hrs.)
- Fee of $67 at time of submission
Additional items if lapsed:
Fee $84
<6mo: no other changes
>6mo but <12mo: 48 total CEs required
Additional Items if lapsed more than 1 year
>12mo but <24mo: 60 total CEs required, pass written and skills tests, Live Scan, $122
Paramedic
Paramedic
- Copy of current gov. issued ID
- Copy of current CPR card(AHA or equivalent)
- Copy of Current CA Paramedic license
- Download the Accreditation Form 2402 (to be completed with your employer within 45 days)
- Copy of ACLS and PALS/PEPP cards
- Fee of $102 at time of submission
Paramedic
- Copy of current gov. issued ID
- Copy of current CA Paramedic License
- Copy of 2404 Paramedic Skills Competency Verification Form
- Copy of form 2403
- Copy of ACLS and PALS/PEPP cards
- No Fee if submitted prior to expiration date. (If lapsed: Fee $47)
CFRN
- Copy of current gov. issued ID
- Copy of current CA RN license
- Copy of Current CRFN Certification (if CFRN is in process, request form for statement of employer attestation)
- Fee of $42 at time of submission
- Copy of current gov. issued ID
- Copy of current CFRN Certification
- Copy of current CA RN license
- Fee of $30 at time of submission
If lapsed: $37
MICN
- Copy of current gov. issued ID
- Copy of current CA RN license
- MICN Ride Along Form
- Copy of current CPR card (AHA or equiv.)
- Copy of ACLS recognition
- Copy of PALS recognition
- Copy of MICN Course Completion Certificate/or Copy of MICN Authorization from another LEMSA. Approval is required by the Nor-Cal EMS Medical Director
- Fee of $102 at time of submission
- Copy of current gov. issued ID
- Copy of current CPR card (AHA or Equiv.)
- Copy of ACLS recognition
- Copy of PALS recognition
- Copy of current MICN Authorization
- Copy of current CA RN license
- Fee of $32 at time of submission
- Fee of $32 at time of submission