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PDF [1MB]
EMS-Driver/EMT/AEMT/Paramedic Initial/Renewal PDF Fillable for mail-in or counter service Application
PDF [1MB]
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PDF [633KB]
Course Medical First Responder Initial-Completion Roster and Instructions
PDF [633KB]
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PDF [234KB]
Course Request and Instructor Verification Form
PDF [234KB]
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PDF [115KB]
Office of Emergency Planning and Response Course Roster
PDF [115KB]
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PDF [308KB]
Verification of Instructor Emergency Driving Classes Guidelines
PDF [308KB]
This form contains the requirements to be an EMSD Instructor. This should be completed, submitted, and approved on any new EMSD Instructor prior to teaching the class.
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PDF [138KB]
EMS Driver Course Roster
PDF [138KB]
This form is the class roster and should be completed and submitted the day after class is finished.
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PDF [244KB]
Paramedic Course Initial-Completion Rosters
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.
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PDF [186KB]
EMT Course Initial-Completion Rosters
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.
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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.
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PDF [117KB]
Course Request Form (MFR, EMT, Paramedic, Driver)
PDF [117KB]
This form should be completed for any course request and must be submitted no later than 30 days prior to the start of the class.
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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.