Get Ny Doh-65 2009-2026
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How to fill out the NY DOH-65 online
The NY DOH-65 form is an essential application for obtaining Emergency Medical Services certification in New York. This guide will provide step-by-step instructions for filling out the form online, ensuring you complete each section accurately and efficiently.
Follow the steps to complete the NY DOH-65 form online
- Press the ‘Get Form’ button to access the NY DOH-65 form and open it in the editor.
- Begin filling out the form legibly, ensuring that you use capital letters or type your responses as required.
- Enter the course number in the designated box. This number is provided by your instructor or course coordinator.
- Select the appropriate checkbox for 'Original Certification' if it is your first application or if you are applying for certification in a new category. Alternatively, select 'Recertification' if you are renewing your certification.
- If you have an EMS identification number, enter the six-digit number in the appropriate box. If your number is less than six digits, precede it with zeros.
- Input your last name, followed by your first name and middle initial. If your name includes a suffix (e.g., Jr.), place it after your last name.
- If your name has changed or does not match what appears on your current EMS card, check the box and enter your correct name in the provided space.
- Fill in your mailing address accurately. The first line should include your street number and name, while the second line is for your city, state, and the third line for zip code and county.
- Specify the county where you reside by entering the appropriate name or code.
- Input your date of birth in the format of MM/DD/YYYY, ensuring you use two digits for each component.
- Provide the last four digits of your Social Security number, which will remain confidential.
- Indicate your sex by marking 'M' for male or 'F' for female.
- If applicable, check the box to indicate that you are part of the teaching faculty for this course.
- Enter your primary and secondary EMS agency codes if you are affiliated with any EMS agency.
- Fill in the date of your Practical Skills Exam as directed by your instructor.
- Enter the date for the New York State written examination, also determined by your instructor.
- Read the affirmation statement carefully and sign your name as you normally would, followed by today's date to certify the accuracy of your application.
Complete your NY DOH-65 form online today and secure your Emergency Medical Services certification.
To become EMT certified in New York, you must complete an approved training program and pass the National Registry of Emergency Medical Technicians (NREMT) exam. Additionally, you need to meet the NY DOH-65 certification requirements, which include submitting an application and background check. USLegalForms can assist you in navigating certification paperwork, making the process smoother.
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