Re-Certification EMR Application Logo
  • Emergency Medical Responder Re-Certification Application

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  • Per Instructions: Please allow 5-7 business days for processing


  • YOU MUST ANSWER THESE QUESTIONS OR APPLICATION WILL BE REJECTED

     

  • If yes, provide a detailed statement below describing the crime(s), date, location, court, sentence served and parole if any. 

  • If yes, attach an explanation that describes the action, any corrective action, and/or remediation as a result of the action.

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  • The Medical Director shall deny or revoke an Emergency Medical Responder Certificate if any of the following apply to the applicant:

    a.  has committed any sexually related offense specified under Section 290 of the Penal Code

    b.  been convicted of murder, attempted murder or murder for hire

    c.  been convicted of two or more felonies

    d.  is on parole or probation for any felony

    e.  been convicted and released from incarceration during the preceding fifteen years of the crime of manslaughter or involuntary manslaughter

    f.  been convicted and released from incarceration during the preceding ten years for any offense punishable as a felony

    g.  been convicted of two misdemeanors within the preceding five years for any offense relating to the use, sale, possession or transportation of narcotics or addictive or dangerous drugs

    h.  been convicted of two misdemeanors within the preceding five years for any offense relating to force, violence, threat or intimidation

    i.  been convicted within the preceding five years of any theft related misdemeanor

    j.  has committed any act within the preceding seven years involving fraud or intentional dishonesty for personal gain

  • Required Documents

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  • Additional documents may be sent via email to Certifications@mvemsa.com, please use last name in subject line.

  • Applications missing required documentation/information will be delayed

  • Payment Information

  • EMR Re-Certification $30 ~     ~    ~ Late Fee (if applicable) $15

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    • YOUR EMPLOYER WILL BE INVOICED FOR CERTIFICATION & LATE FEES 

    • YOUR EMPLOYER WILL BE INVOICED FOR CERTIFICATION FEES ONLY 

    • ALL LATE FEES ARE THE RESPONSIBILITY OF APPLICANT

    • PLEASE NOTE: APPLICATION WILL NOT BE PROCESSED UNTIL PAYMENT IS RECEIVED

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