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National Registry EMT Application Questions

Applicants should be aware that the following questions are asked on the National Registry EMT Application:

National Registry EMT Application Questions

EMT Application Questions

1._Do you or have you had within the past 10 years, any physical or mental condition that impairs, could impair, or has impaired your ability to perform the duties of an EMT? If you answer yes, explain whether your condition is controlled by medication or other treatment and how your condition treated or untreated, affects your ability to perform the duties of an EMT.

2. Do you or have you used in the last 10 years, any drug or chemical substance for other than legitimate medical purposes that impairs or has impaired your ability to perform the duties of an EMT?

3. Have you been counseled about, diagnosed with, or treated for, a dependency on alcohol or drugs within the last 10 years?

4. Have you ever been arrested, charged with, or convicted of any misdemeanor or felony? (Minor traffic violations need not be reported.)

5. Has an employer or supervising physician taken disciplinary action against you related to your duties as an EMT? (Discipline includes suspension, letter of reprimand, resignation in lieu of termination, a limitation or restriction of scope of practice or dismissal for cause.)

6. Have you been named in a lawsuit alleging medical malpractice or misconduct related to providing medical care?

7. Have you ever been disciplined, denied or revoked by the National Registry of EMTs or any health care certifying/licensing agency?

8. Have you ever surrendered or resigned a health care license or certificate?

9. Have you lived, worked or attended school outside of Oregon for 60 or more consecutive days in the last 5 years?

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