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 *

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Age *

Gender *

• Male
• Female

Paramedic NREMT Psychomotor Exam dates *

• July 15, 2023 - Register by: June 30, 2023
• October 7, 2023 - Register by: September 22, 2023
• December 16 2023 - Register by: December 1, 2023

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

Emergency Contact *

First

Last

Emergency Contact

Emergency Contact Phone Number *

Relationship to student *

Where did you hear about us?

• Web Search
• Facebook
• Twitter
• In-Person Event
• Referral from Friend/Colleague
• Other

If Other, Please tell us more.

Submit