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TX HHS EMS Certificate/Wallet Card Replacement Form 2021-2025 free printable template

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EMS Licensing Unit MC 1876 P.O. Box 149347 Austin, Texas 787149347 Main: (512) 8346734 Fax (512) 2063779 Email: EMSCert@dshs.texas.govTo request a replacement EMS wallet card, submit completed form
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How to fill out TX HHS EMS Certificate/Wallet Card Replacement Form

01
Obtain the TX HHS EMS Certificate/Wallet Card Replacement Form from the official website or your local EMS office.
02
Fill out your personal information including name, address, and contact details accurately.
03
Provide your current EMS certification number and the reason for requesting a replacement.
04
Check if you need to attach any supporting documents, such as a copy of your ID or prior certification.
05
Review the form for any errors or missing information.
06
Sign and date the form to certify that all information is accurate.
07
Submit the completed form either online or at your local EMS office as per the instructions provided.

Who needs TX HHS EMS Certificate/Wallet Card Replacement Form?

01
EMS personnel who have lost their certificate or wallet card.
02
Individuals whose EMS certification has been damaged or is no longer legible.
03
Those who need an updated version of their certificate due to changes in personal information.
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Requirements You must be at least 18 years old. Have a high school diploma or GED certificate. Successfully complete a DSHS approved EMS training course. Submit a completed EMS Personnel Certification application and fee. Pass the National Registry exam. Submit fingerprints for Texas/FBI criminal history check.
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Requirements You must be at least 18 years old. Have a high school diploma or GED certificate. Successfully complete a DSHS approved EMS training course. Submit a completed EMS Personnel Certification application and fee. Pass the National Registry exam. Submit fingerprints for Texas/FBI criminal history check.
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The TX HHS EMS Certificate/Wallet Card Replacement Form is a document used to request a replacement for a lost or damaged Emergency Medical Services (EMS) Certificate or Wallet Card issued by the Texas Health and Human Services.
Individuals who have lost or damaged their EMS Certificate or Wallet Card issued by Texas Health and Human Services are required to file this form to obtain a replacement.
To fill out the TX HHS EMS Certificate/Wallet Card Replacement Form, you need to provide your personal information, details about the certificate or card that needs replacement, and any relevant identification information as specified in the form.
The purpose of the TX HHS EMS Certificate/Wallet Card Replacement Form is to formally request the replacement of an EMS Certificate or Wallet Card to ensure that EMS personnel have valid documentation of their certification.
The information that must be reported on the TX HHS EMS Certificate/Wallet Card Replacement Form includes the applicant's name, contact information, the details of the lost or damaged certificate/card, and any identification numbers associated with the original certificate.
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