Skip to main content

Certification Request Form

Certification Requet Form Instructions

  1. Paramedic / Paramedic Student: Complete parts A, B, C and D. Submit form to your Service or Educational Institute
  2. Paramedic: If applicable, please also submit the Certification Referral Form to RPPEO at certification@rppeo.ca

PART A: PARAMEDIC INFORMATION

Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input

PART B: PARAMEDIC EDUCATION HISTORY

PRIMARY CARE PARAMEDIC PROGRAM

Invalid Input
Invalid Input
Invalid Input
Invalid Input

ADVANCED CARE PARAMEDIC PROGRAM

Invalid Input
Invalid Input
Invalid Input
Invalid Input

PART C: PARAMEDIC EMPLOYMENT & CERTIFICATION HISTORY

Please include all certification history that has occurred within the 10-year period immediately preceding this application

MOST RECENT EMPLOYMENT

Invalid Input
Invalid Input


Invalid Input
Invalid Input
Invalid Input

ADDITIONAL EMPLOYMENT

Invalid Input
Invalid Input


Invalid Input
Invalid Input
Invalid Input

ADDITIONAL EMPLOYMENT

Invalid Input
Invalid Input


Invalid Input
Invalid Input
Invalid Input

PART D: AUTHORIZATION FOR RELEASE OF INFORMATION

Invalid Input
♿

XAccessibility Options♲