Emt Reciprocity Application

Download a blank fillable Emt Reciprocity Application in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Emt Reciprocity Application with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Emergency Medical Technician (EMT)
State of Illinois
Illinois Department of Public Health
Reciprocity Application
EMT Reciprocity Application Instructions
PLEASE NOTE: If you have been trained by an emergency medical services (EMS) system in Illinois and have taken the
National Registry exam, you do not need to apply for reciprocity. The EMS system coordinator for the system where you
were trained needs to submit the necessary documentation to the attention of the Licensure Section at the address below.
Reciprocity is only for those who have not received training in Illinois.
In order to obtain Illinois reciprocity:
1. Complete Part I of the EMT Reciprocity Application.
2. Attach photocopies of your EMT certificate or license and current American Heart Association Healthcare Provider
Cardiopulmonary Resuscitation (CPR) card or equivalent.
3. Provide a letter from the EMS medical director indicating that you are in good standing and up-to-date with continuing
education hours if you currently participate in an EMS system under an EMS medical director. If you cannot obtain a letter
of recommendation, you will need to request a waiver as described in item 4.
4. If you have not functioned as an EMT or under the direction of an EMS medical director, include a letter with your signature
stating that you have never worked as an EMT or under an EMS medical director and request that the letter of recommenda-
tion be waived. Also, if you are requesting a waiver, you will need to provide photocopies of all continuing education you
have completed during your current license/certification period.
5. Complete Part III and Part IV of the application. This information is required. Application will not be processed if incomplete
and/or requested documents are not provided. Other applicable forms are available at
Send the application, fee and all requested documents in one envelope to:
Illinois Department of Public Health
Division of Emergency Medical Systems and Highway Safety
Attention: Reciprocity
422 South Fifth Street, Third Floor
Springfield, Illinois 62701
An Illinois EMT license will be mailed to you after verification that you have met all the requirements for licensure. If you have
any questions, please call 217-785-2080, or send an e-mail to: DPH.EMTLIC@illinois.gov.
Once you have been issued an Illinois EMT license you must adhere to Section 515.590 EMT License Renewal, of the
Illinois Emergency Medical Services and Trauma Center Code (77 Ill. Adm. Code 515.590).
IOCI 12-0537
Page 1 of 4

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 4