Get Nys Doh Cli Forms 2423

Filling out the Nys Doh Cli Forms 2423 is an essential step for individuals seeking instructor certification in New York State. This guide will provide clear and supportive instructions to help you complete the form with ease and confidence.

Follow the steps to successfully complete your form online

1. Click the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by completing Section A, which includes applicant information. Fill in your contact details such as your last name, first name, address, and phone numbers. Ensure that you also include your email address and date of birth.
3. In Section B, provide the name of the EMS agency where you have actively provided ongoing, direct, hands-on pre-hospital patient care. Include the start and end dates of your experience, as well as the agency code.
4. Obtain the required signatures from the Chief Operations Officer or an equivalent supervisor at your EMS agency. Ensure that the supervisor's name and date are also included.
5. Review the certification requirements for the designated role you are applying for (Certified Lab Instructor or Certified Instructor Coordinator) and prepare the necessary supporting documents as outlined in the application instructions.
6. Carefully read Section C, Personal Affirmation, and ensure you meet the outlined criteria. Complete the affirmation and provide your signature and date in the designated areas.
7. Once you have filled out all sections of the form, check for any errors or missing information. Save your changes, and proceed to download or print the completed form for submission.
8. Submit the completed application along with all required original documents to the Bureau of EMS Central Office for processing.

Take the next step towards obtaining your certification by completing your Nys Doh Cli Forms 2423 online today.