Texas has five levels of certification. The highest is Licensed Paramedic, followed by EMT-Paramedic, EMT-Intermediate, EMT-Basic and Emergency Care Attendant (ECA). To view EMS certification/licensure rules and policies, visit our Rules/Policies page.
EMS degree programs are available, though many courses are offered through technical programs and others are approved through programs outside college settings. In Texas, EMS training programs are approved and monitored by staff in field offices located throughout the state. Contact the field office nearest you for information on available EMS courses.
Application and exam process for all applicants
Note that the processes for state application and National Registry application are separate and distinct. You must pass the NR exam to become eligible for state certification; therefore, you must meet all requirements (such as application, fee, etc.) set forth by NR. To view NR requirements, go to www.nremt.org. If you want to work in Texas, you must gain state certification by following the application instructions below. You are allowed to take the NR exam prior to submitting your state application.
You must be at least 18 years old
Have a high school diploma or GED certificate
Successfully complete a DSHS approved EMS training course
Submit a completed EMS Personnel Certification application and fee
Pass the National Registry exam
Submit fingerprints for Texas/FBI criminal history check.
Paramedic licensure applicants are required to follow the steps above and submit proof of either a two-year EMS degree or a four-year degree in any field. See equivalency.
If you are out of state see reciprocity.
Apply online or submit the initial application with fee, if not exempt to:
Texas Department of State Health Services
Attn: Cash Receipts Branch, MC2003
PO Box 149347
Austin, Texas 78714-9347
Application processing takes approximately four to six weeks. If your application is incomplete, your processing will be delayed.
The Texas Department of State Health Services (DSHS) uses the National Registry Assessment Exam as the state-approved exam.
• You will be responsible for scheduling an exam with National Registry at www.nremt.org.
• In addition to the state application fee, you will be required to pay a testing fee to National Registry.
• If you fail the exam, you can not gain certification through another option.
• If you fail the exam, you will be given opportunities to retake the exam.
If you need an exam accommodation, you will be required to submit a separate request to the NR office. You will be required to meet the NR policy requirements for exam accommodations.
The NR office will notify you of your exam score and, if necessary, will provide retest instructions. For information about National Registry computer-based testing (CBT), visit our Exam Information page.
All applicants will be required to undergo an FBI fingerprint criminal history check. You can submit fingerprints through the Fingerprint Applicant Services of Texas (FAST) form. The form includes instructions for scheduling your appointment with L-1 Identity Solutions for fingerprinting, or you may visit their website. Any fees associated with this process will be your responsibility.
If you are unable to go to the L-1 solution site please contact EMS Compliance and Quality Assurance at: 512/834-6700, to receive a hard copy fingerprint card. Please note this will delay our agency receiving your results up to several weeks and requires a law enforcement agency to process your prints.
State Certification Status
After you take the exam you may monitor the certification search page for your state certification status.
The web page will not show your exam score. It will provide your certification status information, i.e. "Certified" if you pass the exam AND all requirements have been met, or "Pending deficiencies" if there are deficiencies on your state application. The state office will not receive notice of your NR deficiencies. NR will contact you directly. If you have questions about your state application deficencies, please contact our office at 512-834-6700.
If you have questions on exam content, grade subscales or additional copies of grade reports, contact National Registry.
You can expect to receive your Texas certificate/license and ID card approximately four to six weeks after submitting your COMPLETED state application form, if all requirements are met. If your application is incomplete, your certification will be delayed and you will be notified in writing by EMS Certification.
If you have questions about your state certification/license status, you may contact us at EMSCert@dshs.texas.gov; 512-834-6700 (phone); or 512-834-6714 (fax). Written correspondence can be mailed to: Department of State Health Services, Attn: EMS, MC2003, PO Box 149347, Austin, Texas 78714-9347.