Get Basic Continuing Education Report

Completing the BASIC CONTINUING EDUCATION REPORT is essential for maintaining your certification as an emergency medical technician. This guide will provide you with clear instructions on how to accurately fill out this form online, ensuring all required information is submitted correctly.

Follow the steps to complete your report online.

1. Press the ‘Get Form’ button to access the BASIC CONTINUING EDUCATION REPORT and open it in your preferred format.
2. Begin by entering your Public Safety Identification number. This is a crucial identifier for your registration.
3. Indicate your EMS affiliation by selecting 'Yes' or 'No,' then provide your last name, first name, and middle initial.
4. Fill in your mailing address, including address line 1, address line 2 (if applicable), city, state, and ZIP code.
5. Enter your driver’s license number, home telephone number, cellular telephone number, and email address to ensure accurate communication.
6. Report the date of submission by entering the month, day, and year.
7. Answer the violation statement questions regarding any arrests or convictions and related reporting history.
8. Provide your signature to affirm the truthfulness of the information submitted and include the date of your signature.
9. Indicate your NIMS/ICS training status and whether you are willing to assist in disaster situations.
10. List all current affiliations with ambulance provider organizations by providing names, certification numbers, addresses, and contact details.
11. Complete Section I by documenting your continuing education hours, including dates, number of hours, and topics covered along with the signatures of instructors.
12. Fill out Section II for EMT Basic audit and review hours, including the required six hours and relevant information.
13. Document the skills proficiency evaluation in Section III, ensuring all appropriate topics and signatures are recorded.
14. Once you have filled out all sections, you can save changes, download, print, or share the form as needed.

Complete your BASIC CONTINUING EDUCATION REPORT online to ensure your certification stays current and your professional credentials remain valid.