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Emergency Medical Services
  • Office of EMS
  • About the Board of EMS
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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) Rev 5-2022
  • 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) Rev 1-25-2023
  • 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 Education (PH-2388)

AEMT

  • 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
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Fitness and Nutrition

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Resources for Healthier Living

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Department of Health
Ralph Alvarado, MD, FACP Commissioner

710 James Robertson Parkway
Nashville, TN 37243
tn.health@tn.gov
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