Forms

Course Authorization

CAN
Course Authorization Request
Distance Learning Form
CAN Modification Form
Roster Form - for Initial, Final or Amended rosters
Samples
Initial Roster
Final Roster
Practical Site Summary - for EMR and EMT courses
Sample Site Summary

EMR Training forms

Training and Testing Verification form - includes EMR application
Verification of Training at Alternate Site - to take the practical exam with another Training Program
National Registry Site Code Instructions - If your EMS agency or EMRA will hold a full EMR course to train National Registry EMR's you will need to get your own Site Code. This link also has instructions for adding Application levels for Training Programs and instructions for adding a Program Director.

Please contact us with any questions or suggestions for this page.

Emergency Systems
Oklahoma State Department of Health
123 Robert S Kerr Ave, Suite 1702
Oklahoma City, OK 73102-6406
Office: (405) 426-8480
Fax: (405) 900-7560 or 4059007560@Xmedius.com (using email)
Esystems@health.ok.gov

Education Forms