Get Tn Ph-3937 2019-2026

The TN PH-3937 form is essential for individuals seeking licensure or certification in emergency medical services in Tennessee. This guide will walk you through each section of the form, ensuring you understand how to complete it accurately and efficiently online.

Follow the steps to complete your application successfully.

1. To begin, click the ‘Get Form’ button to access the TN PH-3937 form. This will allow you to open the document in your preferred editor.
2. Fill in the 'Lic/Cert level requesting' section by selecting the appropriate level for which you are applying, such as EMR, EMT, AEMT, Paramedic, or EMD.
3. Enter your Social Security number in the designated field. If you do not have one, be prepared to submit verification of your citizenship or qualified alien status as required.
4. Provide your date of birth using the format MM/DD/YYYY in the specified fields.
5. Complete the 'Name' section by entering your last name, first name, and middle name, if applicable.
6. Fill in your mailing address, including street number, city, state, and zip code.
7. Provide your personal telephone number and your work telephone number in the appropriate fields.
8. Indicate whether you would like to receive notifications from the Department of Health via email by selecting 'Yes' or 'No' and provide your email address if you answered 'Yes.'
9. Select your race from the provided options.
10. Indicate whether you have a high school diploma or a GED by checking 'Yes' or 'No' for each.
11. Specify your gender by selecting 'Male' or 'Female.'
12. Answer whether you have ever been licensed or certified in other states or with the national registry by checking 'Yes' or 'No.' If 'Yes,' list the details required.
13. Respond to the legal questions related to past convictions or license disciplinary actions. If you answer 'Yes' to any, provide the necessary details on a separate sheet.
14. Review that all information on the form is accurate. You will need to provide your signature and the date to certify the truthfulness of the provided information.
15. Once you have filled out the form, you can save your changes, download a copy, print it for your records, or share it as needed.

Complete the TN PH-3937 form online today to ensure your application for EMS licensure or certification is processed smoothly.