The Kentucky Board of Emergency Medical Services has a variety of forms that can assist you in many aspects of your dealings with the office. We have compiled all of the forms that we offer here in one location.
Application for an EMS Agency license.
DO NOT USE THIS APPLICATION FOR RENEWALS! Go to your KEMSIS Account to Apply for Renewals.
Form used to notify KBEMS of the addition or replacement of ground ambulances or aircraft.
This form is also available electronically through KEMSIS. Log in to your account and apply online.
Advanced EMT (AEMT)
Click 'Address Instructions' to go to the instruction page on how to update your address.
Click on the 'KEMSIS' to take you to your online account where you can update it.
Instructions on how to apply for a duplicate card online.
Link to your KEMSIS Account.
Name Change Instructions
Instructions on how to change your name online.
Link to Your KEMSIS Account
Continuing Education Request
This form is to be used by non-affiliated Emergency Medical Services-Training and Educational INstitutions to request EMS conference/symposium continuing education approval. The completed form and supporting documentation must be submitted to the Director of Education and Training at least 30 days prior to the start of the training.
Course Notification and Number Request can now be completed online!
If you must use paper (processing time is much longer for paper submissions) this form allows you to notify the Board of EMS of courses you are holding and request a course number.
Logon to KEMSIS to Renew your TEI License.
Application for New or Upgrading TEIs.