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License Renewals, Upgrades, & Change of Unit

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License Renewals, Upgrades, & Change of Unit

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If you have already submitted your on-line license application and now need to submit additional documentation – Please do not submit another on-line application. Please email the required document(s) directly to EMSlicensing@dos.nh.gov and reference “Missing Parts” in the subject line of the email – Thank You!. Instructions To be able to re-license online you must supply the LIN number that you received in a mailing from the Division and supply a scanned copy of your National Registry Card. Note: You must complete the Protocol Exam prior to submitting your application for licensure. * = Required Field
Renewal or Change of Level*
- Renewal
- Change of Level
EMS Provider License Type*
- Apprentice
- EMR
- EMT
- AEMT
- Paramedic
- NH EMT (Non NREMT)
LIN
Current National Registry of EMTs Number*
Current NH EMS License Number*
Legal Name*
First Middle Last Suffix
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender
- Male
- Female
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Email*

Email Note: an email that is unique to you is required. Your EMS license will be emailed to this address. You will not receive a mailed hardcopy of your new license card.
Best Contact Phone Number*
Phone number type*
- Cell
- Home
- Work
Last four digits of social security number*
Are you affiliated with a NH licensed EMS Unit?*
- Yes
- No
By licensing as a non-affiliated EMS provider, you certify that you have no affiliations with any licensed EMS unit.*
- I agree
- I disagree
Affiliation Note: To be licensed as an EMS provider in the State of New Hampshire you must be affiliated with at least one NH licensed EMS unit. If you list a unit below that you are not already affiliated with, your application may be delayed until we can contact an authorized representative from the unit to approve your affiliation request. You can also have an authorized representative send an email directly to emslicensing@dos.nh.gov requesting and approving your affiliation.
Unit Affiliation*
Agency Head/Chief/Training Officer Name*
Agency Head/Chief/Training Officer Email address*
Upload current CPR card:*
Upload Apprentice Provider Affiliation form*
You can download a sample of this form here: https://www.nh.gov/safety/divisions/fstems/ems/documents/sampleapprentice.pdf
Please upload a copy of your NREMT Card*
Upload other additional documentation
Drop files here or
Please upload any additional documentation that may be need. This may include any additional information you would like to submit.
FOR INFORMATION PURPOSES ONLY: Applicant Status with Primary Unit: (check one)
- Full-time
- Part-time
- Call
- Volunteer
AFFIRMATION STATEMENT
“I have never been convicted of or found guilty of an offense pursuant to RSA 153-A:13, I (h) and I am in full compliance with RSA 153-A, and the rules adopted thereunder.”
I AFFIRM AND AGREE TO THE ABOVE STATEMENT Pursuant to RSA 153-A*
- YES
- NO
“I swear or affirm that the information provided is accurate to the best of my knowledge. I understand that providing false information shall be grounds for denial, suspension, or revocation or license.”
I AFFIRM AND AGREE TO THE ABOVE STATEMENT Pursuant to RSA 153-A*
- YES
- NO
Signature*
Date signed*
Date Format: MM slash DD slash YYYY

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About
- Who We Are
  Meet the Director
  
  Staff & Instructors
  
  History
  
  “First Alarm” Series
  
  Facilities
  Richard M. Flynn Training Facility, Concord
  
  Raymond S. Burton Training Facility, Bethlehem
  
  Northern EMS Field Office, Gorham
  
  Training Props
  
  Apparatus
  
  Training Grounds Coffeehouse
  
  Initiatives
  COVID-19
  
  Automated External Defibrillator Registry
  
  Organization
  Fire Standards & Training Commission
  
  Emergency Medical & Trauma Services Coordinating Board
  
  Medical Control Board
  
  Trauma Medical Review Committee
  
  Bureau of Certification and Support
  
  Bureau of Emergency Medical Services
  
  Bureau of Firefighter Training
News
Courses
- Courses
  Course Catalog
  
  Examinations
  
  Course & Examination Schedule
  
  Online Classroom
  
  Registration
  
  Course Registration
  Register Today
Licensing
Resources
- Student Resources
  Support
  
  Online Classroom
  
  Student Handbook
  
  Fire Certification Reciprocity
  
  How to Become a First Responder
  
  BLS Eligibility to Test Application
  
  First Responder Resources
  A Guide for New Fire Chiefs
  
  COVID-19
  
  EMS Accolades Report
  
  Licensing for Emergency Medical Services
  
  Patient Care Protocols (Version 8.0)
  
  Preplanned EMS Standby Coverage Best Practices
  
  Statewide Employment Opportunities
  
  Department Resources
  Academy Resource Request
  
  Department Information Update
  
  Department Training Request
  
  Instructor & Coordinator Resources
  Academy Resource Request
  
  Continuing Education Submission Form
  
  Curricula
  
  EMS Instructor/Coordinator Resource Manual
  
  EMS Request for Examination
  
  Initial Course Request Form
  
  Instructor Application & Renewal
  
  Instructor Mentoring Program
  
  Instructor Policies
  
  Online Course Intake Request
  
  Paramedic Interfacility Transfer Instructor Materials
  
  Practical Exam Evaluator Trainer Education
Events