Get Ems Reciprocity/challenge Application Packet - Doh Wa

Filling out the EMS Reciprocity/Challenge Application Packet is an important step for individuals seeking certification as emergency medical service providers in Washington State. This guide provides a comprehensive overview of each section and field of the application to assist you in completing it accurately and effectively.

Follow the steps to successfully complete the application.

1. Click ‘Get Form’ button to access the application form online and open it for editing.
2. Review the contents list included at the beginning of the document to familiarize yourself with all required sections, including important Social Security Number (SSN) information and mailing details.
3. Navigate to the Application Instructions Checklist and verify each requirement necessary for your application type, whether you are applying for Reciprocity or Challenge.
4. Fill out the demographic information section carefully, providing your Social Security Number, National Provider Identifier Number (if applicable), full legal name, birth date and place, address, and contact details.
5. Answer the personal data questions truthfully, providing explanations and additional documentation if you respond 'yes' to any questions regarding fitness to practice.
6. Complete the education section by listing your relevant education and training, attaching necessary documentation as requested.
7. If applicable, detail any other licenses, certifications, or registrations you hold, along with the relevant states and status.
8. Confirm your completion of AIDS education and training, affirming you meet the minimum learning requirements outlined.
9. Sign the applicant’s attestation after reviewing the statements and ensuring all information is accurate and complete.
10. Attach your proof of identity, such as a current photograph from a government-issued ID, verifying your date of birth.
11. Once all sections are filled out, save your changes, and either download, print, or share the completed application as instructed.

Take the first step towards your EMS certification by completing the application online today.