Forms & Applications
Initial Instructor Certification
| EMS Instructor Initial Application | EMS 0086 | PDF Word |
| Assistant EMS Instructor Initial Application | EMS 5902 | PDF Word |
| EMS Continuing Education Instructor Initial Application | EMS 0089 | PDF Word |
| Physician EMS Instructor Initial Application | EMS 0052 | PDF Word |
| Physician Continuing Education Instructor Initial Application | EMS 0052 | PDF Word |
| Fire, Assistant Fire and/or Fire Safety Inspector Instructor Initial Application | EMS 0107 |
Live Fire Instructor
Certification requirements vary depending on when an individual was certified as a Fire Instructor or Assistant Fire Instructor. If you received your Fire Instructor or Assistant Fire Instructor certification prior to January 1, 2018 you may be eligible for a full or partial exemption (“grandfathering”) from completing the Live Fire Instructor certification requirements.
Click HERE for additional information on the Live Fire Instructor Certification, including course entrance requirements, certificate qualifications, and exemption ("grandfathering") options.
NOTE: If ineligible for the exemption (“grandfathering”), the Live Fire Instructor application will be made available upon completion of course and job performance certification requirements.
Reinstatement Applications
| EMS Application - Reinstatement | EMS 0088 | PDF Word |
| EMS Instructor Reinstatement Application | EMS 5922 | PDF Word |
| Assistant EMS Instructor Reinstatement Application | EMS 5923 | PDF Word |
| EMS Continuing Education Instructor Reinstatement Application | EMS 5924 | PDF Word |
| Firefighter, Fire Safety Inspector, and/or Hazard Recognition Officer Reinstatement Application | EMS 0116 | |
| Fire, Fire Safety Inspector and/or Live Fire Instructor Reinstatement Application | EMS 0109 | PDF Word |
Reciprocity Packets & Applications
Application Fee: $75.00 application fee required with EMS provider reciprocity applications (check/money order payable to “Ohio Treasurer of State”). There are no reciprocity application fees for firefighter or fire instructor.
| EMS Provider (EMR, EMT, AEMT, Paramedic) For purposes of granting reciprocity, the State Board of Emergency Medical, Fire, and Transportation Services may review EMS license or certification requirements in other states, the district of Columbia, or the U.S. military to identify those that are substantially similar to the curriculum and certification standards set forth in Chapter 4765.01 of the Ohio Revised Code and Chapters 4765-1 to 4765-19 of the Ohio Administrative Code. |
EMS 5911 | PDF Word |
| EMS Instructor For purposes of granting reciprocity, the State Board of Emergency Medical, Fire, and Transportation Services may grant an individual who has completed a course of instruction in teaching methodology in another state, the district of Columbia, a United States territory, as a member of the armed forces of the United States military, the Ohio national guard, the Ohio military reserve, the Ohio naval militia, the national guard of any other state or a reserve component of the armed forces of the United States, or the United States coast guard, a certificate to teach as an EMS instructor, if the applicant meets all of the requirements set forth in 4765-18 of the Ohio Administrative Code. |
EMS 1647 | PDF Word |
| Firefighter (Volunteer, FFI, FFII) For purposes of granting reciprocity, the executive director may review firefighter licensing or certification requirements and firefighter training standards from another state, the District of Columbia, a United States territory, any branch of the United States military, or other firefighter training program approved by the Division of EMS executive director to identify those requirements and standards that are substantially similar to the curriculum and certification standards as set forth in Chapters 4765-20 and 4765-24 of the Ohio Administrative Code. |
EMS 5917 | PDF Word |
| Fire Instructor For purposes of granting reciprocity, the executive director may review firefighter instructor licensing or certification requirements and firefighter instructor training standards from another state, the District of Columbia, a United States territory, any branch of the United States military, or, other fire instructor training program approved by the executive director, to identify those requirements and standards that are substantially similar to the curriculum and certification standards set forth in section 4765.55 of the Ohio Revised Code and Chapters 4765-21 and 4765-24 of the Ohio Administrative Code. |
EMS 5918 | PDF Word |
Certifications not eligible for certification via reciprocity per the Ohio Administrative Code:
- Fire Safety Inspector
- Hazard Recognition Officer
- Assistant EMS Instructor
- Assistant Fire Instructor
- Live Fire Instructor
Request for Extension
| Request for Extension of EMS Certificates | EMS 0084 | PDF Word |
| Request for Extension of Fire Certificates | EMS 0129 | PDF Word |
Request for Exemption
| Exemption Request For Continuing Education For EMS Certificates | EMS 5933 | PDF Word |
| Exemption Request for Continuing Education for Fire Certificates | EMS 1103 | PDF Word |
Grant Applications & Forms
Priority 1 Training & Equipment Grant
Priority 1 applicants shall apply online. Instructions to create an account may be found in our user guide. For assistance logging on to the grants application website, please email our help desk, or call 614-752-6487.
APPLY
| Priority One Grant Extension Request for Training | Word | |
| Financial Hardship Application | EMS 0003 | PDF Word |
| Training and Equipment Approved Reimbursement List | EMS 0076 | |
| Fiscal Address Verification Form | PDF Word | |
Sample Only Forms |
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| Sample Training and Equipment Grant Application Priority 1 | EMS 1803 | |
| Sample Supplemental Grant Application | EMS 1805 | |
| Sample Research Grant Application Priority 2-5 | EMS 2083 | |
Please email the Grants Section if you have any questions about grant application forms.
Medical Transportation Checklists & Forms
The way you apply for, renew, and manage your medical transportation license has changed.
A new online system has been developed called MTLS Online. We will no longer accept paper applications and forms. All fees must be paid via credit card or Automated Clearing House (ACH).
To register with Identity Manager or log into the MTLS Online System use the following link: https://services.dps.ohio.gov/EMSMTLS.
CLICK HERE for help registering and navigating in the new system.
Inspection Forms
The following inspection forms are provided to assist you in preparing for your inspection. They are the same forms the inspector will use during the inspection.
Ambulance |
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| Headquarters Facility Inspection Emergency Medical Service | EMS 4014 | PDF Word |
| Ambulance Inspection | EMS 4016 | PDF Word |
| Satellite Facility Inspection Emergency Medical Service | EMS 4015 | PDF Word |
| Non-transport Vehicle Inspection | EMS 4026 | PDF Word |
| Periodic Mechanical Safety Report | EMS 4039 | PDF Word |
Ambulette |
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| Headquarters Facility Inspection Non-Emergency Medical Service | EMS 4017 | PDF Word |
| Ambulette Inspection | EMS 4019 | PDF Word |
| Satellite Facility Inspection Non-Emergency Medical Service | EMS 4018 | PDF Word |
| Ambulette Employee Files | EMS 4044 | PDF Word |
| Periodic Mechanical Safety Report | EMS 4039 | PDF Word |
MoICU |
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| Headquarters Facility Inspection Mobile Intensive Care Service | EMS 4020 | PDF Word |
| MoICU Inspection | EMS 4022 | PDF Word |
| Satellite Facility Inspection Mobile Intensive Care Service | EMS 4021 | PDF Word |
| Non-Transport Vehicle Inspection | EMS 4026 | PDF Word |
| Periodic Mechanical Safety Report | EMS 4039 | PDF Word |
Air Service |
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| Headquarters Facility Inspection Air Medical Service | EMS 4023 | PDF Word |
| Aircraft Inspection | EMS 4025 | PDF Word |
| Satellite Facility Inspection Air Medical Service | EMS 4024 | PDF Word |
Sample Only Forms
The following forms are for reference only. The functions of each of these forms is no longer done on paper but through the MTLS Online System. To register with Identity Manager or log into the MTLS Online System, use the following link: https://services.dps.ohio.gov/EMSMTLS.
CLICK HERE for help registering and navigating in the new system.
Ambulance / MoICU |
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| Application for Ambulance or Mobile Intensive Care License | EMS 4001 | |
| Additional Ambulance / MOICU / Non-Transport Vehicle | EMS 4006 | |
| Deletion of Ambulance | EMS 4012 | |
| Headquarters Change of Address | EMS 4004 | |
| Application for New Satellite | EMS 4005 | |
| Temporary Ambulance / MoICU / Non-Transport Vehicle | EMS 4009 | |
| Change in Level of Service Medical Transportation Organization | EMS 4011 | |
| Renewal Application for Ambulance or Mobile Intensive Care | EMS 4040 | Ambulette |
| Application for Ambulette License | EMS 4002 | |
| Additional Ambulette | EMS 4007 | |
| Temporary Ambulette Application | EMS 4010 | |
| Renewal Application for Ambulette License | EMS 4041 | |
Air Medical |
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| Application for Air Medical License | EMS 4003 | |
| Additional Aircraft | EMS 4008 | |
| Deletion of Aircraft | EMS 4013 | |
| Temporary Aircraft | EMS 4046 | |
| Renewal Application for Air Medical License | EMS 4042 | |
Violation Notification |
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| Violation Notification | EMS 4029 | |
Complaint Form
| Complaint Form for EMS, Fire or Medical Transportation | EMS 0050 | PDF Word |
Medical Transportation Additional Resources |
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| Ambulette Employee Physician Statement Resource | ||
| Daily Vehicle Inspection Log Resource | ||
Fire Charter Program Administration
| Fire Charter Renewal Application | EMS 0027 | PDF Word |
| Fire Charter Program Director Guidebook | EMS 0028 | |
| Fire Charter Application | EMS 0029 | PDF Word |
| Written Examination Proctor Manual | EMS 0030 | |
| Ohio Chartered Fire Training Program Change Notification | EMS 0083 | PDF Word |
| Request for Fire Training Offsite Location | EMS 1270 | PDF Word |
| Written Testing Agreement Chartered Fire Training Programs | EMS 1105 | PDF Word |
| Request for Change to Practical Skill Sheet | EMS 1264 | PDF Word |
EMS and Fire Course and Exam Administration
Fire Charter Course Materials
Firefighter
| Volunteer Firefighter Course Packet | EMS 0309 | |
| Firefighter I Transition Course Packet | EMS 0307 | |
| Firefighter I Course Packet | EMS 0304 | |
| Firefighter II Transition Course Packet | EMS 0308 | |
| Firefighter I & II Course Packet | EMS 0303 | |
| Volunteer Firefighter Course Objectives Check-Off | EMS 0114 | PDF Word |
| Firefighter I and II Course Objectives Check-Off | EMS 0121 | PDF Word |
| Courage to be Safe: Sixteen Life Safety Initiatives Course | ||
Hazardous Materials Awareness & Operations |
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| Hazardous Materials Awareness and Operations Course Packet | EMS 0205 | |
Fire Safety Inspector |
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| Fire Safety Inspector Course Packet | EMS 0226 | |
| Fire Safety Inspector Course Objectives Check-off Packet | EMS 0312 | PDF Word |
Hazard Recognition Officer |
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| Hazard Recognition Officer Course Packet | EMS 0311 | |
| Hazard Recognition Officer Course Objectives Check-off Packet | EMS 0312 | PDF Word | Emergency Vehicle Operations |
| Emergency Vehicle Operations Course Packet | EMS 0210 | Fire Instructor |
| Ohio Fire and EMS Instructor Curriculum | EMS 0122 | |
| Fire Service Training Module | EMS 1109 | |
| Live Fire Training Awareness Module | EMS 1110 | |
| Live Fire Training Awareness Course Instructor Guide – Contact the Division of EMS | ||
| Live Fire Training Awareness Course Student Guide – Contact the Division of EMS | ||
| Live Fire Training Awareness Course PPT Slides – Contact the Division of EMS | ||
Fire Safety Inspector Instructor |
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| Ohio Fire and EMS Instructor Curriculum | EMS 0122 | |
| Fire Safety Inspector Training Module | EMS 0202 | |
Live Fire Instructor (LFI) |
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| Live Fire Training Operations Course Information | EMS 1107 | |
| Live Fire Training Operations Course Instructor Guide – Contact the Division of EMS | ||
| Live Fire Training Operations Course Student Guide – Contact the Division of EMS | ||
| Live Fire Training Operations Course PPT Slides – Contact the Division of EMS | ||
| Live Fire Training Operations Job Performance Requirement Check-Off Packet | EMS 1112 | PDF Word |
Fire Charter Course Examinations
General Course Examination Documents and Policies
| Written Examination Proctor Manual | EMS 0030 | |
| Written Testing Agreement Chartered Fire Training Programs | EMS 1105 | PDF Word |
| Request for Change to Practical Skill Sheet | EMS 1264 | PDF Word |
Practical Skills Evaluation Training |
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| Practical Skills Evaluator Training Course Manual | EMS 1260 | |
| Firefighter Practical Skills Evaluator Training (Training program being revised; currently unavailable) | ||
| Practical Skills Evaluator Training Program Frequently Asked Questions | EMS 1108 | |
Practical Skills Evaluation – Skill Sheets |
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| Volunteer Firefighter Practical Skills Examination Packet | EMS 0206 | PDF Word |
| Hazard Recognition Officer Practical Skill Sheets (Packet) | PDF Word | |
| Fire Safety Inspector Practical Skill Sheets (Packet) | PDF Word | |
| Effective 1/1/21 Firefighter 1 Practical Examination Skill Sheets | EMS 5919 | PDF Word |
| Effective 1/1/21 Firefighter 2 Practical Examination Skill Sheets | EMS 5920 | PDF Word |
| Effective 1/1/21 Fire Safety Inspector Practical Examination Skill Sheets | EMS 5921 | PDF Word |
| Effective 1/1/21 Hazard Recognition Officer Practical Examination Skills Sheets | EMS 5925 | PDF Word |
EMS Training Program Administration
| Certificate of Accreditation Application | EMS 1652 | PDF Word |
| Written Testing Agreement EMS Accredited Institutions | EMS 1106 | PDF Word |
EMS Training Program Curriculum & Education Standards
| Ohio Approved EMS Curriculum Standards – EMS Instructor Guidance (February, 2012) | ||
| National EMS Education Standards | ||
| Rescue Task Force Awareness Training Module | PowerPoint |
Archived EMS Curricula
The following archived curricula were used for classes that began prior to September 1, 2012. To request a copy of an archived curriculum, email EMS Education or call the Education & Testing section at (800) 233-0785 or (614) 466-9447.
- 1994 Emergency Medical Technician-Basic: National Standard Curriculum
- 1998 Emergency Medical Technician Paramedic: National Standard Curriculum
- Emergency Medical Technician: Basic Refresher Curriculum (October, 2003)
- First Responder Training Program Ohio Approved Curriculum (February, 2009)
- Ohio EMT - Intermediate Curriculum and Transitional Course (March, 2002)
- Ohio EMT - Intermediate Refresher Curriculum (March, 2004)
- Ohio EMT - Paramedic Refresher Curriculum (January, 2004)
EMS Training Program Instructor Information
| Written Examination Proctor Manual | EMS 0030 | |
| Ohio Fire and EMS Instructor Curriculum | EMS 0122 | |
| Ohio EMS Instructor Curriculum Mentorship Program for Assistant EMS Instructors | EMS 0128 | |
| EMS Instructor Orientation |
More Forms
| Request for Replacement Card | EMS 0079 | PDF Word |
| Change of Address | EMS 0080 | PDF Word |
| Declaration of Criminal History EMS Certificates | EMS 0095 | PDF Word |
| Declaration of Criminal History Fire Certificates | EMS 0101 | PDF Word |
| Complaint Form for EMS, Fire, or Medical Transportation | EMS 0050 | PDF Word |
| Application Fee / Disciplinary Payment Remittance | EMS 1101 | PDF Word |
| Regional Physician Advisory Board Membership Application | EMS 0096 | PDF Word |
| EMS / FIRE Agency Information Update Guide |
Related Links
Have Questions?
Email us
at Ask EMS
Or call (614) 466-9447 or (800) 233-0785