Get State Of California Emt Skills Competency Verification Form Emsa Scv 0810

The State Of California EMT Skills Competency Verification Form EMSA SCV 0810 is an essential document for verifying the skills and competencies of individuals seeking EMT certification or recertification. This guide will walk you through the process of completing the form online in a clear and structured manner.

Follow the steps to successfully complete the form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by entering your name in section 1a as it appears on your EMT-I certificate. Make sure to write your last name first.
3. In section 1b, input your EMT-I certificate number. This is the number provided on your current or most recent EMT-I certification.
4. For section 1c, ensure you sign the form to verify that the information you provided is accurate and that you have demonstrated competency.
5. In the 'Verification of Competency' section, begin with item 1. For each skill listed, indicate the name of the training program or EMS service provider affiliated with the qualified individual verifying your competency.
6. For each skill demonstrated, enter the date when the skill was verified. This date should reflect the actual observation or simulation contact.
7. The qualified individual verifying competency must sign next to the skill along with printing their name. Ensure that their certification or license number is also included.
8. Repeat the verification process for each of the skills listed on the form. Each skill requires a separate signature and date.
9. Once all sections are completed, review the form for accuracy. You can then save your changes, download the form, print it, or share it as necessary.

Complete the State Of California EMT Skills Competency Verification Form online today to ensure your recertification process goes smoothly.