Step 2: Provide the information to this office This form MUST be printed out to complete and to obtain the necessary signatures. Step 1: Complete the Personal Status Change Application (PDF) Please print out the form, complete the application and obtain the required signatures. Note: Application forms provided can no longer be filled out on the computer and printed. Changes can be made on the paper application or through the Online Renewal process. The Personal Status Change Application provides the process for updating an EMS certification record when a person's name, address or agency changes.
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June 2023
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