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Bureau of Emergency Medical Services
New or Lapsed/Re-applying Licensing Process

As of January 1, 2017, all new or lapsed/re-applying EMS provider license applicants must complete a Criminal Background Check.

The process for the background check is outlined below:

  1. Fingerprinting by "inked" or LiveScan electronic process (this needs to be completed first)
    Criminal Records Unit Webpage for more information
  2. Complete the Criminal History Record Information (CHRI) Authorization Form
  3. Complete the EMS Provider License Application for New or Lapsed Applicants
  4. Complete a NH Approved level appropriate Scope of Practice Modules program. The listing can be found on our Course Catalog-EMS Courses
  5. Take and pass the NH Protocol Exam at the appropriate level. The exam can be found here: https://nhoodle.nh.gov/ola/course/index.php?categoryid=41
  6. Submit all of the following documents to the Bureau of EMS
    • Completed CHRI Authorization form (a)
    • Fingerprint card OR LiveScan receipt (b)
    • Payment ($47.00) made out to "State of NH-Criminal Records Unit"
    • Completed EMS Provider License Application (c)
    • Copy of National Registry certification card

Mail this packet to:

NHDOS-Bureau of EMS: Licensing
33 Hazen Drive
Concord, NH 03305

Reference Documents:

(a) Criminal History Record Information (CHRI) Authorization FormAdobe Acrobat Reader SymbolCompletion instructions below (d)
(b) Sample LiveScan Fingerprint "receipt"Adobe Acrobat Reader Symbol
(c) EMS Provider License Application form for New or Lapsed ApplicantsAdobe Acrobat Reader Symbol
(d) Instructions for completing the CHRI Authorization FormAdobe Acrobat Reader Symbol
Step by Step: CHRI/EMS applicant Instructions Adobe Acrobat Reader Symbol

Adobe Acrobat Reader Symbol Adobe Acrobat Reader format. You can download a free reader from Adobe.


   
 
New Hampshire Department of Safety | 33 Hazen Drive | Concord, NH 03305
TDD Access: Relay NH 1-800-735-2964
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