Get Regulatory Licensing Unit - Texas Department Of State Health ... - Dshs State Tx

Filling out the Regulatory Licensing Unit form is a critical step in maintaining your certification as an EMS coordinator, instructor, or information operator instructor in Texas. This guide provides clear and supportive instructions to help you complete the application accurately and efficiently.

Follow the steps to fill out the application form online.

1. Click ‘Get Form’ button to access the application form and open it in the appropriate editor.
2. Complete Section 1 by providing your last name, first name, middle name, social security number, address (street, apartment number, or PO Box), city, state, zip code, home phone number, business phone number, and date of birth.
3. Indicate your current level of active EMS certification or licensure by selecting the appropriate box, including ECA, EMT, EMT-I, EMT-P, or LP.
4. In Section 2, indicate your recertification status by checking the applicable box for regular recertification, late recertification, or re-entry recertification.
5. For Section 3, if applicable, provide the name of the sponsoring agency or organization and select the relevant recertification status options.
6. In Section 4, attach necessary certificates for any regional updates attended and list all educational institutions and qualified entities related to your clinical and field internships.
7. If you are a military personnel, check the appropriate box in Section 5 to indicate your status and request expedited processing if desired.
8. In Section 6, specify the level(s) for which you are applying, and select the appropriate application fee, ensuring your payment method is noted.
9. Finally, complete Section 7 by signing and dating the application to affirm that all provided information is accurate and that you agree to abide by the regulations.
10. Once all fields are completed, proceed to save changes, download, print, or share the application form as needed.

Complete your application online today to maintain your certification and ensure continued compliance.