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EMS Online
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Office of Emergency Medical Services
Regulation & Compliance Enforcement
Non-Certified Personnel Account Request
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.
Non-Certified Personnel Account Request
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PortalAccountExists
Do you have a Portal Account with OEMS?
(Value Required)
No
Yes
Required
Personnel Details
Please enter SSN (9 digit number only -
999999999
)
(Value Required)
Required
Please re-enter SSN and click continue (9 digit number only -
999999999
)
(Value Required)
Required
Continue
Personal Information
First Name:
(Value Required)
Required
Middle Name:
Last Name:
(Value Required)
Required
Suffix:
Address Line 1:
(Value Required)
Required
SSN:
Address Line 2:
Date of Birth:
(Value Required)
Expected format: MM/DD/YYYY
Required
Zip Code:
(Value Required)
Required
Home Phone:
**
* 9999999999
City:
(Value Required)
Required
State:
(Value Required)
Required
County or City
Currently Living:
(Value Required)
Select One
OUT OF STATE
ACCOMACK
ALBEMARLE
ALEXANDRIA
ALLEGHANY
AMELIA
AMHERST
APPOMATTOX
ARLINGTON
AUGUSTA
BATH
BEDFORD CITY
BEDFORD COUNTY
BLAND
BOTETOURT
BRISTOL
BRUNSWICK
BUCHANAN
BUCKINGHAM
BUENA VISTA
CAMPBELL
CAROLINE
CARROLL
CHARLES CITY
CHARLOTTE
CHARLOTTESVILLE
CHESAPEAKE
CHESTERFIELD
CLARKE
COLONIAL HEIGHTS
COVINGTON
CRAIG
CULPEPER
CUMBERLAND
DANVILLE
DICKENSON
DINWIDDIE
EMPORIA
ESSEX
FAIRFAX
FAIRFAX COUNTY
FALLS CHURCH
FAUQUIER
FLOYD
FLUVANNA
FRANKLIN CITY
FRANKLIN COUNTY
FREDERICK
FREDERICKSBURG
GALAX
GILES
GLOUCESTER
GOOCHLAND
GRAYSON
GREENE
GREENSVILLE
HALIFAX
HAMPTON
HANOVER
HARRISONBURG
HENRICO
HENRY
HIGHLAND
HOPEWELL
ISLE OF WIGHT
JAMES CITY COUNTY
KING AND QUEEN
KING GEORGE
KING WILLIAM
LANCASTER
LEE
LEXINGTON
LOUDOUN
LOUISA
LUNENBURG
LYNCHBURG
MADISON
MANASSAS
MANASSAS PARK
MARTINSVILLE
MATHEWS
MECKLENBURG
MIDDLESEX
MONTGOMERY
NELSON
NEW KENT
NEWPORT NEWS
NON-AFFILIATED
NORFOLK
NORTHAMPTON
NORTHUMBERLAND
NORTON
NOTTOWAY
ORANGE
PAGE
PATRICK
PETERSBURG
PITTSYLVANIA
POQUOSON
PORTSMOUTH
POWHATAN
PRINCE EDWARD
PRINCE GEORGE
PRINCE WILLIAM
PULASKI
RADFORD
RAPPAHANNOCK
RICHMOND CITY
RICHMOND COUNTY
ROANOKE CITY
ROANOKE COUNTY
ROCKBRIDGE
ROCKINGHAM
RUSSELL
SALEM
SCOTT
SHENANDOAH
SMYTH
SOUTHAMPTON
SPOTSYLVANIA
STAFFORD
STAUNTON
SUFFOLK
SURRY
SUSSEX
TAZEWELL
VIRGINIA BEACH
WARREN
WASHINGTON
WAYNESBORO
WESTMORELAND
WILLIAMSBURG
WINCHESTER
WISE
WYTHE
YORK
Required
Business Phone:
**
* 9999999999
Cell Phone:
**
* 9999999999
Email Address:
(Value Required)
Required
Re-Enter Email Address:
(Value Required)
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
*
= Required Fields    
**
= A valid Home Phone or Cell Phone or Business Phone is required for contact information
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