Paramedic NREMT Exam Registration Form

Paramedic NREMT Exam Registration

** IMPORTANT **
Upon submitting your registration form you will receive an email with information about exam day and payment.

Student Information

Name *

First

Last

PSID Number (if Indiana Resident) *

If you are not an Indiana Resident, please put N/A in this field.

PATT # *

Address *

Address Line 1

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

County *

County

Cell *

Email *

Date of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Age *

Gender *

• Male
• Female

Paramedic NREMT Psychomotor Exam dates *

• April 30, 2022 - Register by: April 15, 2022
• July 16, 2022 - Register by: July 1, 2022
• September 3, 2022 - Register by: August 9, 2022
• October 1, 2022 - Register by: September 16, 2022
• December 17, 2022 - Register by: December 2, 2022

Exam Info *

• Full Exam - $300
• Retest - $50 per station, up to 4

Please select appropriate option *

• Testing for the first time
• Retesting

Please check which stations need retesting *

• Out-of-Hospital
• Oral A
• Oral B
• Static
• Dynamic
• Patient Assessment - Truma

Additional information, Questions or Concerns

Submit