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| Affiliation & Student Application Release Form | Maryland Emergency Services Student Application Release and Affiliation Form. |
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| ALS Class Application | Advanced Life Support Application Timelines and the ALS Program Course Approval Application. |
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| Change of Information | This form is to be used for pre-hospital providers who wish to document a change in name, address, or social security number. |
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| Course Request Form | This form is to be used by instructors and/or sponsoring agencies when requesting a BLS course. Must be received at least 20 days prior to class start date. |
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| CRT Relicensing Application | Cardiac Rescue Technician License Renewal Application. For use ONLY by CRT's originally licensed before July 1, 2001. |
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| CRT-99 with National Registry Relicensing Application | Cardiac Rescue Technician License Renewal Application. For use ONLY by CRT's having National Registry EMT-Intermediate/99 Certification. |
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| CRT-99 WITHOUT National Registry Relicensing Application | Cardiac Rescue Technician License Renewal Application. For use ONLY by CRT's NOT having National Registry EMT-Intermediate/99 Certification and originally licensed before July 1, 2001. |
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| EMT-P Relicensing Application | EMT-Paramedic License Renewal Application. This application MUST be received by MIEMSS at least 14 days prior to expiration of your current EMT-P license. |
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| Extension Request | Form for requesting an extension of pre-hospital provider's license or certification. Must be received prior to current license/certification expiration date. |
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| Maryland EMS Continuing Education Course Application | This form is to be used by instructors and/or sponsoring agencies when requesting a Continuing Education number. Must be received at least 14 days prior to class start date. |
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| Surrender Form | This form is to be utilized by Maryland pre-hospital providers when requesting to surrender their current license/certification. |