Forms and Frequently Asked Questions

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 $25.00 per station Total of $100.00

· We do accept credit card payment, money order or cashiers check payable to Midlands EMS, no personal checks.

· 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 the 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

 

_______Airway         

___________Assessment    

_________________Random Skill

____________ CPR/AED

 

If repeat make sure you list skill to repeat