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Forms and Frequently Asked Questions |
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Midlands EMS |
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SC Midlands EMS Management Association 3201 Leaphart Road West Columbia SC 29169 midlandsems.com
Instructions for Basic Practical Testing
· Cost for first time testing is $20.00 per station Total of $80.00 · We do NOT accept personal checks – Must be money order or cashier check payable to Midlands EMS · Money is due in our office one week prior to exam. Please make sure you have sufficient time for mail. Students should not come by our office to pay. · The completed form below should accompany your testing fees. · You should arrive at this office on the morning of your test at 8:30am no later than 8:45. You must present proper ID to DHEC National Registry Representative · Students that are not checked in by orientation at 9:00am will not be allowed to test. · If unable to attend after payment is made please notify this office and we will move you to another date.
Please Print Clearly
Student Name______________________________ Phone Number______________________ School Attended______________________________________ Last 4 digits SS#__ __ __ __ Instructor___________________________________________ Course #_____________________ Completion Date _________________I Instructor Signature_____________________________
_______Airway ___________Assessment _________________Random Skill ____________ CPR/AED
If repeat make sure you list skill to repeat |