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How to Become an EMT in Texas
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From the DSHS Texas website

Initial Certification-Licensure

Texas has five levels of certification. The highest is Licensed Paramedic, followed by EMT-Paramedic, Advanced EMT, 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 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. 

  • Paramedics – Texas has two levels for Paramedics: EMT-Paramedic certification for those who have completed a paramedic course, but have not completed a degree and Paramedic Licensure for those with a two year EMS degree or a four year degree in any field.  

  • Out of County and other healthcare professionals seeking EMS certification please visit our web page on equivalency for Health Care Professionals.

  • If you are an out of state EMS professional see reciprocity.

If you are out of state view reciprocity.


Once you gain National Registry certification and meet all requirements for State certification, then you may apply for Texas certification. Click Apply Online and register as a new user. Then, under the EMS Board, select the application for Initial EMT online, complete the application to include adding the National Registry number and expiration date AND the DSHS course approval number and the course completion date. The course number starts with a 6 and can be found on your course completion document. Once you complete the application, then submit, and pay the non-refundable fee. You should receive an "approved" notification. 

The “approved” means that your submitted application meets the requirements and is now in que to be processed. Current processing may take up to 4 weeks from the date of submission. Please make sure that you schedule your fingerprint-based background check through IdentoGO using DSHS’ code. If there are issues with your application, you will be notified via email. 


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

  • 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 Texas Fingerprint Service Code Form. The form includes instructions for scheduling your appointment with IdentoGo for fingerprinting, Any fees associated with this process will be your responsibility. 

You may schedule your fingerprint-based background check through IdentoGO using DSHS’ code. The code will be provided on the online application and within the application summary or you may email to request the code. 

If you are unable to go to a IdentoGo site please contact EMS Central Unit at: 512/834-6734, to receive a hard copy fingerprint card. Please note this will delay our agency receiving your results up to several weeks.



You can expect to receive your Texas certificate/license and ID in your DSHS account secure mailbox within two weeks after your certification or license is issued.


Information provided on this web page may be abbreviated from EMS laws and rules. For a full explanation or clarification regarding your situation you may need to refer to the appropriate law or rule.

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