Get Doh-4231 2002-2026

This guide provides clear and supportive instructions on how to complete the DOH-4231 recertification form online. Following these steps will ensure that you accurately fill out each section of the form, making the process easier and more efficient.

Follow the steps to fill out the DOH-4231 form online

1. Click the 'Get Form' button to access the DOH-4231 form and open it in the editor for filling out.
2. Enter your EMT number and social security number in the designated fields to uniquely identify your application.
3. Fill in your last name, first name, and middle initial to ensure accurate identification.
4. Provide your complete address, including city, state, and zipcode, for correspondence related to your application.
5. Input your EMS agency code to associate your application with your emergency medical service agency.
6. Read the affirmation regarding misdemeanors and felonies carefully. You must affirm this statement by entering your signature.
7. Indicate the date you are signing the document in the provided field.
8. Have your CPR instructor complete their section by providing their printed name, signature, and date, confirming your CPR certification.
9. Complete the ACLS certification by entering the issue and expiration dates of your current certification card.
10. Detail your refresher training hours by entering the topic and the corresponding hours earned in each category.
11. Record any additional continuing education hours in the specified fields for further verification.
12. Complete the skill competency verification section with the necessary signatures from your Physician Medical Director, along with their printed name and date.
13. Affirm all statements made on the form by signing in the designated area and including the date.
14. Ensure that your sponsoring agency contact or coordinator also signs the form and records the date.
15. Once all fields are completed, save your changes, download or print the document as necessary for your records or submission.

Complete your DOH-4231 recertification form online today for a streamlined process.