Forms

• PDF [1MB] 
  EMS-Driver/EMT/AEMT/Paramedic Initial/Renewal PDF [1MB] 
  Fillable application form for mail-in or counter service
• PDF [1MB] 
  Medical First Responder Course Initial Completion Roster PDF [1MB] 
• PDF [282KB] 
  Course Request and Instructor Verification Form PDF [282KB] 
• PDF [115KB] 
  Office of Emergency Planning and Response Course Roster PDF [115KB] 
• PDF [308KB] 
  Verification of Instructor Guidelines for Emergency Driving Classes PDF [308KB] 
  This should be completed, submitted, and approved on any new EMSD Instructor prior to teaching the class.
• PDF [138KB] 
  EMS Driver Course Roster PDF [138KB] 
  This form should be completed and submitted the day after class is finished.
• PDF [244KB] 
  Paramedic Course Initial-Completion Roster PDF [244KB] 
  The initial roster form should be completed no later than the second class meeting. The completion roster form should be filled out no later than 5 days after the completion of class.
• PDF [186KB] 
  EMT Course Initial-Completion Roster PDF [186KB] 
  The initial roster form should be completed no later than the second class meeting. The completion roster form should be filled out no later than 5 days after the completion of class.
• PDF [61KB] 
  Medical First Responder Skill Competency PDF [61KB] 
  This form should be completed on every person being checked off on First Responder Skills and submitted with completion roster.
• PDF [488KB] 
  EMS Out of State Reciprocity Verification Form PDF [488KB] 
  This form should be completed and submitted to the state or states that the applicant has been previously licensed in prior to applying for a Mississippi Registered EMS license.