Applications and Forms
The following PDF forms are required for completing the application process. Please download and print forms.
Please return all applications to:
Department of Health
Customer Service Office
P.O. Box 47877
Olympia, WA 98504-7877
Call our Customer Service Office at 360-236-4700 if you have questions about Emergency Medical Services (EMS) certification.
All EMS certifications require proof of EMS agency affiliation – active membership, paid or volunteer with a licensed aid or ambulance service.
- Apply Online
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The Washington State Department of Health requires
The Washington State Department of Health requires that only the applicant or licensee may complete an attestation for an application, or for continuing education. This is a legal attestation. Completion of the attestation by anyone other than the applicant may constitute a reportable felony offense. The Department of Health can take action against people for perjury or for making a false statement they know to be false.
For further information please see:
- Continuing Education; WAC 246-12-180; How to prove compliance
- Initial and renewal credentialing of practitioners; WAC 246-12-020; How to obtain an initial credential
Washington State law authorizes the Department of Health to obtain fingerprint-based background checks for licensing purposes. This check may be through the Washington State Patrol and the Federal Bureau of Investigation. We may require this if you have lived in another state or if you have a criminal record in Washington State. This would be at your own expense.
You must pay the application fee at the time you apply. You may use a credit or debit card with a VISA or MasterCard logo, or pay by ACH/E-Check. Please make sure your address on the payment information screen matches the address your financial institution has on file for you. This fee is non-refundable. There is a convenience fee to apply online.
If we need additional documentation, we'll notify you by email.
There are additional items you may need, in addition to your application:
If you have questions, contact our Customer Service staff at 360-236-4700.
Getting started
Online Application Instructions
Online application instructions are on our website.
Online applications are accessed through SecureAccess Washington (SAW) security portal. You'll need to add the Department of Health Online Application Portal - Healthcare Enforcement and Licensing Management System (HELMS) Portal service to access the online applications. The first time you add the service, you'll be prompted to answer several questions to verify your identity. The questions will match the name and address you provide with the existing public record information. Because the questions come from public record, you need to provide a complete address and your full legal name as it appears on your driver's license or birth certificate. You may find you have to enter a former address, especially if your address has changed recently (within the past one or two years) to get the right questions that pertain to your identity. If you don't have sufficient information in the public record to verify your identity and aren't currently credentialed by the Department of Health, then you'll need to submit a paper application, as you won't be able to access the Online Application Portal.
Once you have completed the process, and submitted your application, you will receive an email with your pending credential number, or you may look on Provider Credential Search. Refer to this credential number any time you contact Department of Health or submit paperwork.
- Initial certification – Applying for certification for the first time including upgrade, reciprocity, challenge and reversion
- Expired reactivation – reissuance of an expired certification
- Recertification – renewal of certification
- Provisional certification
- Instructors
- EMS authorized skills and procedures
- Additional forms
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- Out-of-state credential verification (PDF)
- Credential Verification (PDF)
- EMS supervisor/medical program director signature (PDF)
- Personal status change (PDF) – agency and address changes. You may also use EMS certification online to make your changes.
- EMS supervisor change (PDF) – change, add or update an agency supervisor
Certification Requirements
- Advanced emergency medical technician
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Education
Successful completion of department approved advanced emergency medical technician (AEMT) course. Initial course completion certificate issued by the training program.
Applicant must possess a high school diploma or GED.
Postgraduate professional work experience
Applicants are required to be associated with one of the following:
- An EMS agency licensed by the Department of Health (aid or ambulance service)
- A law enforcement agency
- Business with an organized industrial safety team
- Senior EMS Instructors or coordinators teaching at department approved EMS training programs who are unable to be associated with approved agencies above.
Applicants must be recommended for certification by the physician medical program director (MPD) of the county in which the applicant will be working.
State license verification
Applicant lists all states where credentials are or were held, including where applicant has applied but a credential was not granted. A verification form must be completed and submitted by the jurisdiction where the applicant is or was credentialed. Applicant sends form to jurisdiction for completion. The jurisdiction sends completed form directly to the department.
Personal data questions
Applicant must answer the following personal data questions:
- Physical and mental health status Lack of impairment due to chemical dependency/substance abuse
- History of loss of license, certification or registration
- Felony convictions
- Loss or limitations of privileges
- Disciplinary actions, professional liability claims history
An appropriate explanation and required documentation must be sent with positive answers. If there is a positive answer to the professional liability claims history question, the applicant must send an explanation of the nature of the case, data and summary of care given, copies of the original complaint, and the settlement or final disposition. If pending, applicant must indicate status.
Additional information/documents required
- Proof of age; must be 18 years of age or older to be certified per WAC 246-976-141
- Copy of current AEMT course completion certificate
- Successful completion of the AEMT certification examination including written and practical skills exams.
Examination is developed and administered by the National Registry of EMT's (NREMT). Applicant provides proof of successful completion of the NREMT exam.
Process for approving/denying applications
Credentialing staff review the application and supporting documents to make an initial determination of eligibility. The nursing education adviser and licensing manager review and approve applications with questionable verifying documents or otherwise “red flag” applications. Some applications are forwarded to discipline for review and a board member for decision. An applicant will be formally notified of a denial and has the opportunity for a hearing.
Renewal requirements
Advanced emergency medical technicians must renew their license every three years, coinciding with their supervisory EMS agency license expiration month. The licensee must satisfy continuing education requirements for re-certification including knowledge and skills competency. There are no fees charged for EMS recertification.
* Replaces Intermediate Life Support (ILS) and Intermediate Life Support-Airway (ILS-A) technician certifications.
- Emergency medical responder
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Education
Successful completion of department approved advanced emergency medical responder (EMR) course. Initial course completion certificate issued by the training program.
Postgraduate professional work experience
No professional work experience required
Applicants are required to be associated with one of the following:
- An EMS agency licensed by the Department of Health (aid or ambulance service)
- A law enforcement agency
- Business with an organized industrial safety team
- Senior EMS Instructors or coordinators teaching at department approved EMS training programs who are unable to be associated with approved agencies above
Applicants must be recommended for certification by the physician medical program director (MPD) of the county in which the applicant will be working
State license verification
Applicant lists all states where credentials are or were held, including where applicant has applied but a credential was not granted. A verification form must be completed and submitted by the jurisdiction where the applicant is or was credentialed. Applicant sends form to jurisdiction for completion. The jurisdiction sends completed form directly to the department.
Personal data questions
Applicant must answer the following personal data questions:
- Physical and mental health status
- Lack of impairment due to chemical dependency/substance abuse
- History of loss of license, certification or registration
- Felony convictions
- Loss or limitations of privileges
- Disciplinary actions, professional liability claims history
Applicant must answer personal data questions. An appropriate explanation and required documentation must be sent with positive answers. If there is a positive answer to the professional liability claims history question, the applicant must send an explanation of the nature of the case, data and summary of care given, copies of the original complaint, and the settlement or final disposition. If pending, applicant must indicate status.
Additional information/documents required
- Proof of age; must be 18 year of age or older to be certified per WAC 246-987-141.
- Copy of current EMR course completion certificate
- Successful completion of the emergency medical responder certification examination including written and practical skills exams. Examination is developed and administered by the National Registry of EMT's (NREMT). Applicant provides proof of successful completion of the NREMT exam
Process for approving/denying applications
Credentialing staff review the application and supporting documents to make an initial determination of eligibility. The nursing education adviser and licensing manager review and approve applications with questionable verifying documents or otherwise “red flag” applications. Some applications are forwarded to discipline for review and a board member for decision. An applicant will be formally notified of a denial and has the opportunity for a hearing.
Renewal requirements
Emergency medical responders must renew their license every three years, coinciding with their supervisory EMS agency license expiration month. The licensee must satisfy continuing education requirements for re-certification including knowledge and skills competency. There are no fees charged for EMS recertification.
- Emergency medical technician
-
Education
Successful completion of department approved emergency medical technician (EMT) course. Initial course completion certificate issued by the training program.
Applicant must possess a high school diploma or GED.
Postgraduate professional work experience
Applicants are required to be associated with one of the following:
- An EMS agency licensed by the Department of Health (aid or ambulance service
- A law enforcement agency
- Business with an organized industrial safety team
- Senior EMS Instructors or coordinators teaching at department approved EMS training programs who are unable to be associated with approved agencies above.
Applicants must be recommended for certification by the physician medical program director (MPD) of the county in which the applicant will be working.
State license verification
Applicant lists all states where credentials are or were held, including where applicant has applied but a credential was not granted. A verification form must be completed and submitted by the jurisdiction where the applicant is or was credentialed. Applicant sends form to jurisdiction for completion. The jurisdiction sends completed form directly to the department.
Personal data questions
Applicant must answer the following personal data questions:
- Physical and mental health status
- Lack of impairment due to chemical dependency/substance abuse
- History of loss of license, certification or registration
- Felony convictions
- Loss or limitations of privileges
- Disciplinary actions, professional liability claims history
An appropriate explanation and required documentation must be sent with positive answers. If there is a positive answer to the professional liability claims history question, the applicant must send an explanation of the nature of the case, data and summary of care given, copies of the original complaint, and the settlement or final disposition. If pending, applicant must indicate status.
Additional information/documents required
- Proof of age; must be 18 years of age or older to be certified per WAC 246-976-141
- Copy of current EMT course completion certificate
- Successful completion of the EMT certification examination including written and practical skills exams.
Examination is developed and administered by the National Registry of EMT's (NREMT). Applicant provides proof of successful completion of the NREMT exam
Process for approving/denying applications
Credentialing staff review the application and supporting documents to make an initial determination of eligibility. The nursing education adviser and licensing manager review and approve applications with questionable verifying documents or otherwise “red flag” applications. Some applications are forwarded to discipline for review and a board member for decision. An applicant will be formally notified of a denial and has the opportunity for a hearing.
Renewal requirements
Emergency medical technicians must renew their license every three years, coinciding with their supervisory EMS agency license expiration month. The licensee must satisfy continuing education requirements for re-certification including knowledge and skills competency. There are no fees charged for EMS recertification.
- Paramedic
-
Education
Successful completion of department approved paramedic training course. Applicants who graduated from paramedic training after June 30, 1996 are required to have graduated from a paramedic training program that is accredited by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP).
Applicant must possess a high school diploma or GED.
Postgraduate professional work experience
Applicants are required to be associated with one of the following:
- An EMS agency licensed by the Department of Health (aid or ambulance service)
- A law enforcement agency
- Business with an organized industrial safety team
- Senior EMS Instructors or coordinators teaching at department approved EMS training programs who are unable to be associated with approved agencies above
Applicants must be recommended for certification by the physician medical program director (MPD) of the county in which the applicant will be working.
State license verification
Applicant lists all states where credentials are or were held, including where applicant has applied but a credential was not granted. A verification form must be completed and submitted by the jurisdiction where the applicant is or was credentialed. Applicant sends form to jurisdiction for completion. The jurisdiction sends completed form directly to the department.
Personal data questions
Applicant must answer the following personal data questions:
- Physical and mental health status
- Lack of impairment due to chemical dependency/substance abuse
- History of loss of license, certification or registration
- Felony convictions
- Loss or limitations of privileges
- Disciplinary actions, professional liability claims history
An appropriate explanation and required documentation must be sent with positive answers. If there is a positive answer to the professional liability claims history question, the applicant must send an explanation of the nature of the case, data and summary of care given, copies of the original complaint, and the settlement or final disposition. If pending, applicant must indicate status.
Additional information/documents required
- Proof of age; must be 18 years of age or older to be certified
- Copy of current paramedic course completion certificate
- Successful completion of the Paramedic certification examination including written and practical skills exams. Examination is developed and administered by the National Registry of EMT's (NREMT). Applicant provides proof of successful completion of the NREMT exam (WAC 246-976-141).
Process for approving/denying applications
Credentialing staff review the application and supporting documents to make an initial determination of eligibility. The nursing education adviser and licensing manager review and approve applications with questionable verifying documents or otherwise “red flag” applications. Some applications are forwarded to discipline for review and a board member for decision. An applicant will be formally notified of a denial and has the opportunity for a hearing.
Renewal requirements
Paramedics must renew their license every three years, coinciding with their supervisory EMS agency licensure month. Paramedics must satisfy continuing education requirements for re-certification including knowledge and skills competency. Paramedics may be required to successfully complete a protocol and skills knowledge assessment developed and administered by the Physician Medical Program Director of the County in which the applicant is working. There are no fees charged for recertification of the EMS credential. (WAC 246-976-144 and WAC 246-976-161).
Renewals
- Renew online with EMS certification online
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EMS Certification Online is accessed through SecureAccess Washington (SAW) security portal.
Getting started
To get started you must register with Secure Access Washington (SAW) and sign in to the Department of Health Online Application Portal. Please read Steps 1 and 2 completely before creating your account.
Step 1: Create a Secure Access Washington account.
Go to the Secure Access Washington (SAW) website.
Select "Create One." If you already have a SAW account, sign in with your user ID and password you previously created and continue to "Step 2" below.
Follow the steps to register. You'll create your own user ID and password for SAW.
The system will send you an email confirming your registration.
Select the link in the email that follows this statement: “To activate your new account, select the following link." This step is required to complete the registration process.
If you experience problems with the SAW site, contact Consolidated Technology Services (24 hours) at 888-241-7597 or email servicedesk@cts.wa.gov.
Step 2: create a link to EMS Certification Online
Login to your SAW account using your SAW user ID and password you previously created.
Select the “Add a New Service” link.
On the right column, select “I would like to browse a list of services”
Select ‘Department of Health'
Scroll to “EMS Online Certification”. Select “Apply.”
Click on “My Services” and choose “EMS Online Certification.”
Complete the one-time validation providing your credential number, date of birth and last 4 of your SSN.