WebForms

WebFormDescription
Agency Roster Request (Fire, EMS, and EMA) This form will be used by Indiana Fire, EMS, and EMA agencies wishing to update their roster, and begin to manage it at the local level .
Application for Recertification based on previous Certification This application is for individuals who are seeking Recertification due to expiration of their current EMS certification.
BLS level (EMR or EMT) Reciprocity application This application is for individuals who hold a current and valid certification in another state or National Registry seeking reciprocity for EMR or EMT levels. The individual has taken there course outside of Indiana.
Course Request (Health) Form used to create a request for training through Indiana State Department of Health Division of Emergency Preparedness. Please use this form to request any direct delivery of consortium or ISDH based training and advertise training/events on Acadis.
EMA & Consortium Courses - Course Request Form used to create a request for training through IDHS Division of Training and Preparedness. Please use this form to request any direct delivery of consortium or IDHS based training and advertise training/events on Acadis.
Fire - Certification Exam Retest Request If you need testing codes for a retest Complete this form
General Course Survey
Leadership Training Course Survey
Request for Psychomotor/Practical exam results for National Registry This form is for students to request their psychomotor/practical exam results be sent to National Registry.

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