Get Doh 5064

The Doh 5064 form is essential for individuals looking to recertify their emergency medical technician qualifications in New York State. This guide provides clear and detailed instructions on how to accurately complete the form online, ensuring all required information is provided to avoid delays or rejections.

Follow the steps to successfully complete the Doh 5064 form online.

1. Press the ‘Get Form’ button to obtain the form and open it in your editor.
2. Carefully enter your EMT number, ensuring it is accurate as this is crucial for identification purposes.
3. Input your social security number in the designated fields, ensuring that the format is correct to avoid any issues.
4. Provide your last name, middle initial, and first name in the specified sections. Make sure to print clearly using uppercase letters.
5. Fill in your complete address, including city, state, and zip code, ensuring that all information is current and accurate.
6. Enter the agency code of your participating CME agency. Double-check to make sure this code is correct to avoid complications.
7. Review the required hours of training as per NYS standards. Ensure that you have completed and earned the necessary hours listed.
8. Provide your earned hours in the section designated for 'Hours Earned.' Make sure your total is calculated correctly.
9. Include your CIC signature and CIC number in the respective fields at the bottom of the form.
10. Once all sections are filled out correctly, save your changes, download the completed form, and share or print it as needed.

Complete your Doh 5064 form online today for a smooth recertification process.