Emergency Medical Service Unit
Downloads Applications and Forms
For additional information on Alaska EMS Certification email ems.certification@alaska.govor call 907-465-3029.
Forms for Individuals:
Course Forms
- EMS Course Approval (08/02)
- MICP Initial Course Approval (12/02)
- Instructor Course Approval (08/02)
- EMS Course Completion(04/03)
Certification Forms
- Initial Certification (9/07)
- Recertification (10/09)
- Venipuncture Form for Certification as an EMT-II (02/05)
- Application for Comity Certification (9/08)
- Emergency Medical Dispatcher Initial (9/07)
- Emergency Medical Dispatcher Recertification (10/09)
- Extension Request (10/05)
Course Prerequisites
- Proof of Patient Contacts EMT-II Candidates (10/02)
- Proof of Patient Contacts EMT-III Candidates (10/02)
- Patient Contact Form for EMT-II Candidates (9/05)
- Patient Contact Form for EMT-III Candidates (9/05)
- Medical Director Verification for EMT-II Candidates (08/02)
- Medical Director Verification for EMT-III Candidates (08/02)
- Venipuncture Form for entry into EMT-III Training Programs (12/05)
Instructor Certification Forms
- ETT Instructor Initial (9/07)
- ETT Instructor Recertification (10/09)
- EMT-I Instructor Initial (9/07)
- EMT-II/III Instructor Initial (9/07)
- EMT-I Instructor Recertification (9/07)
- EMT-II/III Instructor Recertification (9/07)
- Medevac Escort Instructor Initial (9/07)
- Reauthorization for Air Medical Escort Instructor (9/08)
- MICP Course Coordinator Initial (1/08)
- MICP Course Coordinator Recertification (9/07)
Frequently Asked Questions about Certification
Forms for Services:
- Basic and Advanced Life Support Ground EMS Unit Application (8/05)
- Medevac Air Medical Service Application (8/05)
- Critical Care Air Ambulance Service Application (8/05)
- Specialty Air Medical Transport Team Application (7/05)
PCR:
Mandatory Reporting:
Expanded Scope
Click here to read more about Expanded Scope of Practice: Adding Additional Medications or Procedures for EMTs.