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EMT Re-Cert Application



The CAL FIRE EMS Program has begun to issue Emergency Medical Technician Re-Certification cards. Through the EMS Program, CAL FIRE employees shall recertify every two years. Seasonal Firefighters are eligible only when employed, but can recertify up to six months early while still working and maintain the same expiration date.
Below is a list for the 1) EMT Application and instructions, 2) Skills Competency Verification form and instructions, 3) Continuing Education Log, 4) Live Scan instructions, form, and fingerprint locations.
The Live Scan form is partially filled out so that all one needs to complete is the applicant section. The sections that are complete pertain to the billing for the EMS Program. Include this form with your EMT re-cert package. You will only need to have Live Scan performed one time with the initial package. Please see the list of those agencies that perform the fingerprinting. Be aware of the costs associated with the fingerprinting. The only fee one needs to pay at the time of fingerprinting is the listed price not the Department of Justice fee. That will be paid by the EMS Program.
The Continuing Education (CE) form must be filled out completely including all CE through Target Solutions. You may include the list from Target Solutions.
The Skills Competency Verification form shall be signed by a Firefighter II or above. The person signing needs to be an EMT.
Lastly, the EMT application needs to be complete. The CAL FIRE EMS Program will not accept applications for EMTs who have never applied through a Local Emergency Medical Services Agency (LEMSA). If a CAL FIRE employee is receiving an EMT certification for the first time, go to the LEMSA.
The CAL FIRE EMS Program requires six weeks to process the application. Please send your completed package to the EMS Coordinator for submission to the EMS Program. Example: If your card expires at the end of March, you will need to have the complete package to the EMS Coordinator by February 15.
• (Section 1) – APPLICATION TYPE: Because this is a new program at CAL FIRE, the application will need to have “Initial“checked and most likely one will check the “Continuing Education” box.
• (Section 2) – ATTACHMENTS: The applicant shall attach all pertinent information, with the exception of “Course Completion Record” and “National Registry.” Include copies of those cards that are required.
• (Section 3) – CENTRAL REGISTRY INFORMATION: Follow instructions.
• (Section 4) – DECLARATION: Follow instructions and include an explanation for any actions taken against your EMT certification. This explanation needs to be on a separate document but included with your application. Be sure to sign and date the document.

If you have questions, please contact the EMS Coordinator

Rob Jenkins (EMS1)

When you have completed your packet turn all documents in to Training at:

Rob Jenkins (EMS1)

Below are the required forms and instructions required for recertification.

2017 Complete EMT Application Packet





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