Forms & Applications
Collection of downloadable Forms in PDF or Word format.
| Title | Code | File |
| 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.
- See more information on the Live Fire Instructor Certification, including course entrance requirements, and certificate qualifications.
Application Fee: $75.00 application fee (check/money order to “Ohio Treasurer of State”) required with reinstatement applications (check/money order payable to “Ohio Treasurer of State”). For EMS Continuing Education Instructor reinstatement, the application fee is $25.
| Title | Code | File |
| 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 |
Reminder: If fire OR EMS certificate reinstatement applications are submitted together, then one $75 fee covers EMS reinstatements and one $75 fee covers fire reinstatements. For example, if you submit a FFII reinstatement independently, it’s $75. A week later, if you submit your Fire Instructor reinstatement, then you will have to pay another $75. If both are submitted at the same time, it would be just one $75 fee for your fire service reinstatements.
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.
| Title | Code | File |
| 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
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 for a Priority 1 Training & Equipment Grant
| Title | Code | File |
| Priority One Grant Extension Request for Training | Word | |
| Financial Hardship Application | EMS 0003 | PDF | Word |
| Training and Equipment Approved Reimbursement List | EMS 0076 | |
| EMS 2-5 Grant Budget Expenditure | EMS 2081 | Excel |
| EMS 2-5 Grant Budget & Extension Request | EMS 2082 | Word |
Priority 2-5 Research Grants
Priority 2-5 Research grant applications are available February 1 - April 1
Sample Only Forms
| Title | Code | File |
| 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.
Apply For, Renew, or Manage a Medical Transportation License
Applying for, renewing, and managing a medical transportation license is done through our online system. All fees must be paid via credit card or Automated Clearing House (ACH).
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
| Title | Code | File |
| Headquarters Facility Inspection Emergency Medical Service | EMS 4014 | PDF | Word |
| Ambulance Inspection Advanced Life Support (ALS) | EMS 4016 | PDF | Word |
| Ambulance Inspection BLS Emergency and Non-Emergency | EMS 4036 | PDF | Word |
| Ambulance Inspection BLS Non-Emergency Only | EMS 4027 | PDF | Word |
| Non-Transport Vehicle Inspection | EMS 4026 | PDF | Word |
| Satellite Facility Inspection Emergency Medical Service | EMS 4015 | PDF | Word |
| Periodic Mechanical Safety Report | EMS 4039 | PDF | Word |
Ambulette
| Title | Code | File |
| 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
| Title | Code | File |
| Headquarters Facility Inspection Emergency Medical Service | EMS 4014 | PDF | Word |
| MoICU Inspection | EMS 4022 | PDF | Word |
| Mobile Intensive Care Unit – Mobile Stroke Unit Inspection | EMS 4054 | 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
| Title | Code | File |
| 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.
Air Medical
| Title | Code | File |
| 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
| Title | Code | File |
| Violation Notification | EMS 4029 |
Complaint Form
| Title | Code | File |
| Complaint Form for EMS, Fire or Medical Transportation | EMS 0050 | PDF | Word |
Medical Transportation Additional Resources
| Title | Code | File |
| Ambulette Employee Physician Statement Resource | ||
| Daily Vehicle Inspection Log Resource |
| Title | Code | File |
| 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 |
Firefighter
| Title | Code | File |
| 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
| Title | Code | File |
| Hazardous Materials Awareness and Operations Course Packet | EMS 0205 |
Fire Safety Inspector
| Title | Code | File |
| Fire Safety Inspector Course Packet | EMS 0226 | |
| Fire Safety Inspector Course Objectives Check-off Packet | EMS 0312 | PDF | Word |
Hazard Recognition Officer
| Title | Code | File |
| Hazard Recognition Officer Course Packet | EMS 0311 | |
| Hazard Recognition Officer Course Objectives Check-off Packet | EMS 0312 | PDF | Word |
Emergency Vehicle Operations
| Title | Code | File |
| Emergency Vehicle Operations Course Packet | EMS 0210 |
Fire Instructor
| Title | Code | File |
| Ohio Fire and EMS Instructor Curriculum | EMS 0122 | |
| Fire Service Training Module | EMS 1109 | |
| Live Fire Training Awareness Module | EMS 1110 |
Fire Safety Inspector Instructor
| Title | Code | File |
| Ohio Fire and EMS Instructor Curriculum | EMS 0122 | |
| Fire Safety Inspector Training Module | EMS 0202 |
Live Fire Instructor (LFI)
| Title | Code | File |
| Live Fire Training Operations Course Information | EMS 1107 | |
| Live Fire Training Operations Job Performance Requirement Check-Off Packet | EMS 1112 | PDF | Word |
General Course Examination Documents and Policies
| Title | Code | File |
| 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
| Title | Code | File |
| Practical Skills Evaluator Course Manual | EMS 1260 | |
| Firefighter Practical Skills Evaluator Training | PowerPoint | |
| Practical Skills Evaluator Training Program Frequently Asked Questions | EMS 1108 |
Practical Skills Evaluation - Skill Sheets
| Title | Code | File |
| Volunteer Firefighter Practical Skills Examination Packet | EMS 0206 | PDF | Word |
| Firefighter 1 Practical Examination Skill Sheets | EMS 5919 | PDF | Word |
| Firefighter 2 Practical Examination Skill Sheets | EMS 5920 | PDF | Word |
| Fire Safety Inspector Practical Examination Skill Sheets | EMS 5921 | PDF | Word |
| Hazard Recognition Officer Practical Examination Skills Sheets | EMS 5925 |
CE Program Coordinator’s Guidebook — The Handbook is currently being updated. Questions regarding EMS continuing education should be directed to the Division of EMS Education Section at EMSEducation@dps.ohio.gov.
| Title | Code | File |
| Initial Application for Certificate of Approval | EMS 1650 | Word |
| Certificate of Approval - Renewal Application | EMS 1651 | Word |
| Title | Code | File |
| Psychomotor Examination Manual EMR and EMT Level | EMS 0119 | PDF | Word |
| Certificate of Accreditation Renewal Application | EMS 1659 | PDF | Word |
| Certificate of Accreditation Application | EMS 1652 | PDF | Word |
| Written Testing Agreement EMS Accredited Institutions | EMS 1106 | PDF | Word |
| Request for EMS Training Offsite Location | EMS 1269 | PDF | Word |
| Title | Code | File |
| Ohio Approved EMS Curriculum Standards – EMS Instructor Guidance (February, 2012) | ||
| 2009 National Ems Education Standards (Currently in affect) | ||
| Rescue Task Force Awareness Training Module | PowerPoint | |
| 2021 National EMS Education Standards (for reference only) |
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 Instructor Initial Certification Information
| Title | Code | File |
| 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 |
| Title | Code | File |
| 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 |