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  • Doh-4231 2020

Get Doh-4231 2020-2025

NEW YORK STATE DEPARTMENT OF HEALTH EMT-Paramedic RECERTIFICATION FORM Bureau of Emergency Medical Services Continuing Education Recertification Program Print Neatly in UPPER CASE Letters - Please Complete ALL Information Incomplete forms will be denied and returned EMT Number Social Security Number - Last Name MI First Name Address City State Zip Code Enter Agency Code of Your Participating Agency I affirm that in accordance with the requirements of 10NYCRR Part 800. 8 e I have not been convicted of or am not currently charged with any misdemeanors or felonies. I understand that if I have a conviction it will be individually reviewed and that any such conviction may not be an automatic bar to certification* The Department of Health will determine if the conviction is applicable under the provisions of 10NYCRR Part 800. Applicant s Signature Date CPR Certification A Copy of Current Card front and back MUST Accompany This Application ACLS Certification Skill Competency Verification QA /....

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How to fill out the DOH-4231 online

Filling out the DOH-4231 form is an essential step for EMT-Paramedic recertification in New York State. This guide will provide clear and supportive instructions to help you accurately complete the form online.

Follow the steps to fill out the DOH-4231 form with ease.

  1. Click 'Get Form' button to access the DOH-4231 and open it in the online editor.
  2. Begin by filling in your EMT number and Social Security number accurately. Ensure that your information matches your official documents.
  3. Next, fill out your agency code, last name, first name, middle initial, phone number, address, city, state, and zip code, making sure to use UPPER CASE letters as instructed.
  4. Initial and confirm that you have read and agree to follow all requirements for the NYS Continuing Education Recertification Program as outlined in the CME Program Manual.
  5. Affirm that all statements on the recertification form are true and correct. Sign and date the form where indicated.
  6. If applicable, declare any misdemeanors or felonies in accordance with regulatory requirements. Ensure you understand the implications regarding recertification.
  7. The Physician Medical Director must sign and provide their NYS medical license number. Ensure that their details are accurate and complete.
  8. Complete the section detailing your refresher training hours, ensuring to specify the required and earned hours for each topic area.
  9. Finish by entering your additional continuing education hours, ensuring that all relevant training and competencies are documented.
  10. Once all sections are filled out, review the form for completeness. Save your changes, and if available in the editor, you can download, print, or share the form as needed.

Take the next step in your professional journey and complete your recertification online today!

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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