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EMS Online
Office of Emergency Medical Services
Regulation & Compliance Enforcement
Non-Certified Personnel Account Request
Non-Certified Personnel Account Request
Restart Application
Submit Application
The following page will enable non-certified providers (e.g. drivers, auxiliary members, and others without EMS certification) to register for an EMS number and access EMS Portal.
Do you have a Portal Account with OEMS?
Do you have a Portal Account with OEMS?
No
Yes
Personnel Details
Please enter SSN (9 digit number only)
Required
Please re-enter SSN and click continue (9 digit number only)
Required
Continue
Personal Information
First Name
Required
Middle Name
Last Name
Required
Suffix
Date of Birth
Required
SSN:
Address Line 1
Required
Address Line 2
Zip Code
Required
City
Required
State
Required
County or City Currently Living
Required
Home Phone
**
Business Phone
**
Cell Phone
**
Email Address
Required
Re-Enter Email Address
Required
Agencies
Other Information
Gender:
Select One
Female
Male
Prefer not to answer
Highest level of Education:
Select One
Home School
Not a High School Graduate
High School Graduate/GED
Some College
2 year College Degree
4 year College Degree
Master's Degree
Doctoral Degree
Professional Degree
Prefer not to answer
Marital Status:
Select One
Single
Married
Divorced
Widowed
Prefer not to answer
Annual Income:
Select One
Less than $ 25,000
$ 25,001-$ 50,000
$ 50,001-$ 75,000
$ 75,001 - $ 100,000
$ 100,001 - $ 125,000
$ 125,001 - $ 150,000
More than $ 150,000
Prefer not to answer
Ethnic Origin:
Select One
Hispanic or Latino
Not Hispanic or Not Latino
Prefer not to answer
Race:
Select One
African American or Black
American Indian or Alaska Native
Asian Indian
Chinese
Filipino
Guamanian or Chamorro
Japanese
Korean
Native Hawaiian
Other
Other Asian
Other Pacific Islander
Samoan
Vietnamese
White
Prefer not to answer
Specify Other Race:
Have you ever served in the US Military?:
Yes
No
Prefer Not To Answer
**
= A valid Home Phone or Cell Phone or Business Phone is required for contact information