Emergency Medical Services
EMS Personnel Forms
- Affidavit to Downgrade (PH-4072)
- Affidavit to Retire License (PH-3932)
- EMS Miscellaneous Fees (PH-3940)
- EMS Application and Fees (PH-2397) NEW! 10-2021
- Online License application: http://lars.tn.gov
- Criminal Background Disclosure (PH-3856)
- Declaration of Citizenship Form (PH-4183A) REV 1-13-2021
- Statement of Licensure Level Form (PH-4291)
- Medical Statement Form (PH-0130)
Education Forms
- Application for Course Approval (PH-2792)
- Exam Cover Sheet (PH-3459)
EMR
- EMR Practical Skills Verification (PH-3677)
- EMR Initial Class Folder Checklist (PH-3855)
- Verification of EMR Refresher Training (PH-3933)
EMT
- EMT Initial Class Folder Check List (PH-3945)
- EMT Initial Individual Folder Checklist (PH-3944) Rev. 12-11-19
- EMT Skills Evaluation (PH-3786) Rev 12-16-2020
- Verification of Initial Clinical Training (PH-3787)
- EMS Clinical Assessment for EMT Trainees (PH-3785)
- Verification of Education (PH-2388)
AEMT
- EMS Clinical Assessment for AEMT Trainees (PH-3785)
- AEMT Skills Evaluation (PH-3805) Rev 12-16-2020
- AEMT Class Folder Checklist (PH-3858)
- AEMT Class Individual Folder Checklist (PH-4241) Rev. 12-11-19
Paramedic
- Paramedic Class Folder Checklist (PH-3857)
- Paramedic Skills Evaluation (PH-3806) Rev 7-27-2021
- Paramedic Class Individual Folder Checklist (PH-4240) Rev. 12-11-19
Paramedic - Critical Care
- Verification of Paramedic-Critical Care Training (PH-4239)
- Paramedic-Critical Care Class Folder Checklist (PH-4245) Rev 11-20-19