Forms and Publications

Forms & Publications

NOTE: To preview and download PDF forms, you will need Adobe Acrobat Reader

Instructions for Adobe Fillable Forms 9.20.2019

Initial Education

List of Initial and CE Education Program Sponsors (Revised: 10/2018)
 

Licensing 

All applications for EMS licensure, renewal, and relicensure must be completed on the Michigan EMS eLicensing Portal at: https://www.mi-emsis.org/lms/public/ 
 
  • The following licensing forms are included within the online applications, however, they are being made available here for quick reference should you need to access them outside of the eLicensing portal.
 

Criminal Conviction History Form (Complete and submit with initial licensure application, renewal application, or self-reporting at any time; if applicable)

EMS-252 (Revision: 03/06/19)

Fee Exemption Request Form for Volunteers
 
EMS-144 (Revision: 6/2017)
Instructor Coordinator Field Experience Verification Form
 
EMS-253 (Revision: 6/2017)
Out of State Verification Form (Complete and submit with Reciprocity Application)

EMS-250 (Revision: 03/06/19)

Verification of Education Form (For MFR and EMT National Registry and Reciprocity Applicants whose Education does not Meet Michigan Requirements) EMS-254  (Revision: 03/06/19)

Continuing Education (CE)

List of Initial and CE Education Program Sponsors Revised: 10/2018
Provider (MFR, EMT, EMT-Specialist (AEMT), & Paramedic) CE Record Form

 BETP-EMS-127 5.11.2020

Instructor-Coordinator CE Record Form  IC CE Record Form    1.3.2020
Pre-Approved Standardized CE Credits

 

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