Emergency Medical Services

When completing the application process below, you will be required to submit an official transcript from the institution where you completed your education. The transcript must be mailed directly from the educational institution to the board office located at 665 Mainstream Drive, Nashville, TN 37243.

EMS Personnel Forms

• Affidavit to Downgrade (PH-4072)
• Affidavit to Retire License (PH-3932)
• EMS Miscellaneous Fees (PH-3940)
• EMS Professional Fees (PH-2397) 1-15-2020
• EMS Licensure/Certification Application (PH-3937)
• 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