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Division of State EMS Contact Us Form
Division of State EMS Staff
EMS Agency Leader and EMS Provider to Sign Up for Bureau Briefings
Reportable Incident Report
EMS Complaint Form Submission
ePCR Issues Reporting Form
DOH-5136 Application and Approval for EMS Agency to Use e-PCR
Elite Viewer Access Request Form
NYS ImageTrend Site
NEMSIS Website
NEMSIS v.3 Data Dictionary Information
NYS 3.5.0 Data Dictionary
NYS Facilities List
NYS 3.5.0 Validation Rules
CME Submission Portal
DOH-5065 EMT Recertification Form
DOH-5066 AEMT Critical Care Recertification Form
DOH-5067 AEMT Recertification Form
DOH-4231 Paramedic Recertification Form
DOH-5295 CFR Recertification Form
Agency CME Communication & Registration Portal
DOH-4227 Agency Registration Form
DOH-4281 Certification Extension for Military Personnel
DOH-4245 Registration For Emergency Medical Technicians' Exam, Test Scheduling Request
DOH-4453 Name or Address Change and Duplicate Card Requests
Reasonable Accommodations Request
NYS Student | National Registry Exam Submission
Out of State Reciprocity
Verification of NYS Certification
Education Town Hall Sign Up
EMS Course Paperwork Submission Portal
DOH-65 Application for Emergency Medical Services Certification
DOH-79 Students Ineligible To Take The State Certifying Examination
DOH-3312 Verification of Membership in A NYS EMS Agency
DOH-3379 Medical Director's Certification of AEMT Course Completion
DOH-2733 Final Practical Skills Examination Summary Sheet
Course Signature Form
Student Enrollment
Instructor Management Portal
DOH-3378 CLI Internship Completion Report
DOH-4451 CLI Internship Tracking Form
DOH-2423 Lab Instructor Audit Report
DOH-4452 CIC Internship Tracking Form
DOH-3377 CIC Internship Completion Report
DOH-2424 Didactic Presentation Audit Report
Simulation Debriefing Tool
Course Sponsor Administration Portal
Course Sponsor Recommendation Letter | Instructor Internship
Sponsor Personnel Change Form
Pilot Educational Program Comment & Question Form
Community Internship Education Pilot Program
Leadership Development Pilot Program
Exam Incident Report Form
EMS Agency Renewal Portal
DOH-206 Application for EMS Operating Certificate
DOH-1881 Affirmation of Compliance
DOH-2936 Certified EMS Agency Information Update Form
DOH-4362 Medical Director Affirmation Form
DOH-5131 Funding Document For EMS Agencies
DOH-3826 Application for ALS Agency to Engage in Controlled Substances Activity for Pre-Hospital Care
DOH-3827 Application to be a Controlled Substance Agent for an ALS Agency
DOH-5127 BLSFR Agency Information Application/Update Form
DOH-4135 Notice of Intent to Provide Public Access Defibrillation (PAD)
DOH-2828 EMS Agency Personnel Roster
Controlled Substance Portal
DOH-3848 Semi-Annual Controlled Substance Inventory Form for EMS Agencies
Loss of Controlled Substances Report
New York State Basic Life Support Vehicle Registration Submission Portal
DOH-1881 Affirmation of Compliance Submission Portal
Application for Use of Supraglottic Airway by BLS Providers
REMSCO | REMAC | Program Agency Submission Portal
DOH-3777 Application for New EMS Service, Expansion of Territory or Transfer of Ownership
DOH-3778 Affirmation of Fitness and Competency
DOH-3779 Inspection Report for ALS First Response Vehicles New York State Department of Health
DOH-5800 Rotary Wing Air Medical Service Equipment Waiver Request, Approval and Inspection Under the Provisions of Part 800.27
DOH-3780 Inspection Report for Emergency Ambulance Service Vehicles
DOH-2596 Inspection Report for Certified Ambulance Vehicles
DOH-4362 Medical Director Verification
PECC Program
Always Ready For Children Commitment Letter Submission
Mental Health Poster Request Form
Pediatric Products Request Form
EMS Provider Reporting Long Wait Times at Hospital
EMS Agency Leader and EMS Provider Briefing Question Submissions
EMT-CC Sunset Public Comment
Claim For Payment Submission Portal
Agency Claim for Payment Voucher - AC3253-S
Course Sponsor Claim for Payment Voucher - AC3253-S
Proctor Claim for Payment for Non-State Employees - AC3253-S
Part 18 Submission Portal
DOH-44 Application for a Permit for a Public Gathering
DOH-2332 Part 18 Public Function Event Report
DOH-2342 Part 18 Public Function Medical Incident Log
Regulation: Title: Part 18 - Public Functions With Attendance Of Over 5,000 People | New York Codes, Rules and Regulations (ny.gov)
New York State Mass Gathering Planning Guide: nys-mass-gathering-planning-guide-final-6-12-2018.pdf
For any inquiries, please e-mail the Public Health and Event Safety Unit at: EMS.Part18.Permits@health.ny.gov
NYS EMS Innovation Awards 2026
NYS EMS Annual Awards 2026
Vital Signs Conference Website
Vital Signs Academy