R9-25-403. Application

Requirements for EMCT Certification or Paramedic Endorsement for Providing Critical Care Services (Authorized by A.R.S. §§ 36-2202(A)(2), (A)(3), (A)(4), and (H) and 36-2204(1) and (6)) A. An individual may apply for initial EMCT certification if: 1. The individual is at least 18 years of age; 2. The individual complies with the requirements in A.R.S. § 41-1080; 3. The individual is not ineligible under R9-25-402; and 4. One of the following applies to the individual: a. The individual has not previously applied for certification from the Department or has withdrawn an application for certification; b. An application for certification submitted by the individual was denied by the Department two or more years before the present date; c. Except as provided in R9-25-404(A)(2) or (3), the individual’s certification as an EMCT is expired; d. The individual’s certification as an EMCT was revoked by the Department five or more years before the present date; or e. The individual has current certification as an EMCT and is applying for certification at a different classification level of EMCT. B. An applicant for initial EMCT certification shall submit to the Department an application, including: 1. The following information in a Department-provided format: a. The applicant’s name, address, telephone number, email address, date of birth, gender, and Social Security number; b. The level of EMCT certification being requested; c. Responses to questions addressing the applicant’s criminal history according to R9-25-402(A)(1) through (3) and (C); d. Whether the applicant has within the five years before the date of the application had: i. EMCT certification or recertification revoked in Arizona; ii. Certification, recertification, or licensure at an EMCT classification level revoked, suspended, or voluntarily surrendered in another state or jurisdiction; or iii. Certification or licensure as a health professional, as defined in A.R.S. § 36-3201, revoked, suspended, or voluntarily surrendered in Arizona or in another state or jurisdiction; e. Attestation that all information required as part of the application has been submitted and is true and accurate; and f. The applicant’s signature or electronic signature and date of signature; 2. For each affirmative response to a question addressing the applicant’s criminal history required in subsection (B)(1)(c), a detailed explanation in a Department-provided format and supporting documentation; 3. For each affirmative response to subsection (B)(1)(d), a detailed explanation in a Department-provided format and supporting documentation; 4. If applicable, a copy of certification, recertification, or licensure at an EMCT classification level issued to the applicant in another state or jurisdiction; 5. Documentation for the applicant that complies with A.R.S. § 41-1080; and 6. One of the following: a. Documentation of current registration in a national certification organization at the applicable or higher level of EMCT classification; b. Documentation of completion of training and testing by a branch of the U.S. Armed Forces that is comparable to requirements of a national certification organization for the applicable or higher level of EMCT classification; or c. A certificate of completion showing that, within the two years before the date of the application, the applicant completed statewide standardized training and a statewide standardized certification test. C. A Paramedic applying for endorsement for providing critical care services shall submit to the Department an application, including: 1. The following information in a Department-provided format: a. The applicant’s name, address, telephone number, email address, date of birth, and Social Security number; b. The applicant’s current certification number as a Paramedic; c. Attestation that all information required as part of the application has been submitted and is true and accurate; and d. The applicant’s signature or electronic signature and date of signature; and 2. Documentation of passing a critical care examination given by a national certification organization. D. The Department shall approve or deny an application for initial EMCT certification according to Article 12 of this Chapter. E. If the Department denies an application for initial EMCT certification, the applicant may request a hearing according to A.R.S. Title 41, Chapter 6, Article 10.