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On requirements on the reverse of this application. Section A. Applicant Information Certified Lab Instructor Certified Instructor Coordinator EMT / AEMT Number Last Name First Name, middle initial Address City State County Zip Code Social Security Number Date of Birth Home Phone Work Phone Cell Phone E-Mail Address Section B. CLI/CIC Teaching Experience The above named individual has been employed as a: A. Laboratory Instructor for course number(s): B. Certified Instructor Coor.

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Candidates who pass the basic portion (scoring 70% or higher) and fail the advanced portion (scoring less than 70%) will receive an EMT-D certification card and a failure letter for the AEMT examination. Candidates must retake the entire examination within one year if they wish to be certified at the advanced level.

Certified instructor coordinators must be certified, pursuant to these regulations, at or above the level at which they seek to instruct. This process consists of successfully completing a NYS sanctioned course, the internship requirements, and successfully passing the CLI or CIC written certification exam.

Under medical oversight, EMTs use skills to transport patients safely, perform cardiopulmonary resuscitation (CPR), administer oxygen, administer glucose, and assist patients experiencing asthma attacks or allergic reactions.

If a candidate is unsuccessful on an exam attempt, they may apply to retest 15 days after the last examination. After three unsuccessful examination attempts, EMT, AEMT, and Paramedic candidates must submit official documentation verifying the completion of a remedial training program.

Q: How long is my NYS certification valid for? A: Upon successfully passing the NYS exam, your certificate is valid for 36 months from the last day of the month that you passed your certification examination.

A candidate is allowed to test a single skill station a maximum of three times before he/she must complete a refresher course. Complete general requirements for certification.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232