Use our Online Licensing System to:

• Apply for initial EMS certification/licensure.
• Renew
• Upgrade
• Address Change
• Print certificate/license and ID.
• Criminal History Pre-Screening*

* Pre-Screen Petition for review of Criminal History Pre-Screening is available to those with a criminal history record that may prevent them from being certified or licenses. If you do not have a criminal history record, you do not need to submit a pre-screen application. Before submitting your application or the prescreen petition. DSHS recommends scheduling the fingerprint appointment then on the day of the fingerprint appointment complete the DSHS prescreen petition application. To submit a pre-screen.

The applicant should create a DSHS account and register as a new user. When registering the applicant will be asked to link their license; the applicant will not have a license to add and should skip that section. Once the account is created, then use the pre-screen transaction to begin the review process.

The fee for EMS Criminal History Pre-Screen Petition is $52. Payment may be made by credit card and electronic check.

If you need any of the following forms, click to send prepopulated email to EMS Certification.

• Texas Fingerprint Service Code
• Inactive Certification/Licensure
• Wallet Card Replacement - Include all required information.

Certification/Licensure

Link to initial certification and licensure information.

• Name Change
  Use this form to change your name on your EMS record.
• ECA High School/GED Exemption
  Candidates must meet volunteer criteria listed in Health and Safety Code 773.058. 
• Rule Exemption
  Use this form to request an exemption from EMS rules.  
• Volunteer Verification
  Use this form to verify the volunteer status of an applicant.
• Surrender of EMS Certificate or License
  Use this form to surrender your EMS Personnel certification or license, (EMS) Instructor or Coordinator certificate, (EMS) Initial Education Program, or (EMS) Continuing Education Program, or your Administrator of record (AOR) recognition.

Reciprocity

Link to reciprocity information.

• Out of State Verification Form A
  Submit the Verification Form A to each State where the applicant has ever been certified and/or is currently certified.
• Reciprocity AEMT Skills Out of State Verification Form
  Applicants seeking reciprocity at the Advanced EMT level must have training (verifiable by the certifying state agency) that includes alternative airway intubation devices, and IV initiation as required for Advanced EMT certification in Texas.

Renewal

Link to renewal information.

• Skills Verification Form for Late Renewal
  Applicants completing ALL renewal requirements between date of expiration up to one year after expiration date may submit a late skills verification with their application. 
• Downgrade Statement
  Use this form to apply for lower level of certification.
• Volunteer-to-Paid Status Change
  If you are no longer exclusively a volunteer, you must pay a fee.

Criminal History

Link to criminal history information

Texas Department of Public Safety Access & Dissemination

• Procedure to Access Criminal History Record Information (CHRI)​
• Criminal History Documentation Guide
• Criminal History Report
  This form is intended for certified/licensed EMS to self-report an arrest, indictment, charge, conviction, deferred adjudication community supervision, and/or deferred disposition.
• Work History
  Include your current employer and any EMS providers/First Responder organizations you are affiliated with on the form as a paid or volunteer employee.
• Community Supervision
  This form is used to determine if the Emergency Medical Service (EMS) applicant/certificant/licensee is compliant with his or her community supervision/probation requirements.
• The guide will explain how to complete the following forms:

EMS Coordinators, Instructors, and Information Operators

Link to educator information.

Use our Online Licensing System to:

• Apply for initial certification.
• Renew
• Address Change
• Print certificate and ID

General Forms

• Educator Fee Exemption
• Surrender of EMS Certificate or License
  Use this form to surrender your EMS Instructor or Coordinator certificate, EMS Initial Education Program, or EMS Continuing Education Program.

Education Programs

Link to education programs information.

Courses

• Course Notification Checklist
• Notification/Change

Initial Education Programs

• Initial Application Checklist
• Renewal Application Checklist
• Notification/Change
• EMS Education Program Agreement List

Continuing Education Programs

• Initial Application Checklist
• Renewal Application Checklist
• Notification/Change

Link to provider information.

Applications

• Provider Licensing Application

Use our Online Licensing System to:

• Renew

Administrator of Record

• Administrator of Record Initial Application
• Administrator of Record Renewal Application
• Surrender of EMS Certificate or License
  Use this form to surrender your Administrator of record (AOR) recognition.

Checklists

Use the following checklist as a guide regarding required documentation and elaboration of each provider licensing requirement. 

• EMS Provider Initial License Checklist
• EMS Provider Renewal License Checklist
• EMS Provider Initial Survey Checklist
• EMS Provider Survey FAQs
• EMS Quality Assurance Plan Tool
• Virtual Inspections/Surveys Procedure

Forms

• EMS Provider Declaration
• EMS Personnel
• EMS Station Location List
• EMS Headquarters Physical Location Change
• EMS Vehicles
• Subscription Program Surety Bond
• Medicaid Surety Bonds for Ambulance Providers
• Medical Director
• Notifications/Changes
• Replacement License/Authorization
• Variance Request

Links

• Find the nearest regional office. 
• EMS Patch Information
• Public Records
• Child Abuse Reporting Requirements
• EMSC Resources
• Out-of-Hospital DNR Forms
• Bloodborne Pathogen Reporting Forms
• Clinical Laboratory Improvement Amendments (CLIA)
  The Centers for Medicare & Medicaid Services (CMS) regulates all laboratory testing (except research) performed on humans in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA). EMS Providers are responsible for securing and maintaining a current CLIA Certificate of Waiver. This applies to any firm using glucometers or other devices to test blood or other patient fluids. Find more information from:
  • Texas Health and Human Services
  • Centers for Medicare & Medicaid Services (CMS)

Link to FRO information.

Applications

Use our Online Licensing System to:

• Apply for initial certification.
• Renew

Checklists

• Initial License
• Renewal License

Forms

• Administrator Information
• Medical Director Information
• Personnel
• Notification/Change

Link to maternal designation information.

Applications

• Complete Application for Level I Designation
• Complete Application for Level II-IV Designation

Forms

• Level I Self-Survey Report
• Level I Sample Attestation
• Facility Program Contact Update

Link to neonatal designation information.

Applications

• Complete Application for Level I Designation
• Complete Application for Level II-IV Designation

Forms

• Level I Self-Survey Report
• Level I Sample Attestation
• Facility Program Contact Update

Link to stroke designation information.

Applications

• Complete Application for All Levels

Forms

• Facility Program Contact Update

Link to trauma designation information.

Applications

• Complete Application for All Levels

Forms

• Facility Program Contact Update

Email reports to: CMUReg.svcs@dshs.texas.gov.

• RAC Performance Criteria
• RAC Self-Assessment with Scoring Tool
• EMS/RAC & EMS/RAC Systems Development Narrative Report
• RAC Annual Report Form
• B-13 template
• Board Responsibilities Attestation Form
• EMS Provider Expenditure Report
• EMS Distribution Report
• Quarterly Support Documentation