Get Doh 3312

Filling out the Doh 3312 form is an essential step for verifying membership in a New York State Emergency Medical Services (EMS) agency. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the Doh 3312 form online.

1. Click 'Get Form' button to access the Doh 3312 and open it in the editor. This will allow you to fill out the form electronically, ensuring legibility and accuracy.
2. Begin by filling in the course number, which is essential for your reference. Make sure this number is correct, as it will be required throughout the process.
3. Indicate the purpose of your application by checking the appropriate box for either 'Original Certification' or 'Recertification.' If you are recertifying, include your New York State EMS identification number.
4. Input the applicant's last name, first name, and middle initial (M.I.) clearly in the designated fields. Ensure that you print legibly or type your information.
5. Enter the applicant's Social Security number in the appropriate box. This is crucial for identification purposes.
6. Provide the applicant's date of birth by selecting the month, day, and year from the drop-down menus.
7. If applicable, indicate the primary EMS agency by filling in the agency code. If there is a secondary agency, provide that information in the box provided as well.
8. Enter the primary agency name, ensuring that it matches the official documentation associated with your agency.
9. Complete the section for the primary agency official. This includes the official’s last name, NYS EMS identification number (if available), first name, middle initial, and title.
10. Read the personal affirmation carefully. This statement confirms that the applicant is a member of the primary NYS EMS service. Both the agency official and the applicant must sign and date this section.
11. After reviewing the entire form for accuracy, you can save your changes. Look for options to download, print, or share the completed form as necessary.

Complete your Doh 3312 form online today to ensure smooth processing of your EMS application.