The following are those principles:
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Letter of approval
In the event that a foreign country, state, providence or region of a foreign country and/or school or EMS service requests use of
NREMT certification services that entity must present to the NREMT a letter from that countries governmental authority that they
approve of this use or the letter must state the country has no opposition to the use of the NREMT certification.
EMS Education Approval
The NREMT will authorize EMR, EMT and AEMT certification to graduates who meet and/or exceed the current National EMS Education
Standards as validated by an educational program that is affiliated with CAAHEP accredited paramedic education program and is currently
state approved within the United States. The co-sponsoring institution must have faculty present during the delivery of the course.
At the Paramedic level the education program offered in a foreign country must be affiliated with a U.S. based CAAHEP accredited
Paramedic education program.
Paramedic applicants must hold or have held NREMT Basic certification or a foreign countries equivalent of EMT licensure and have
authorization to practice in that country.
Must be delivered at Pearson Professional Centers or Pearson VUE Select Centers. Examinations must be delivered in English only.
All Psychomotor examinations at the EMT, AEMT and Paramedic levels must be administered by a National Registry Representative,
appointed by the NREMT.
The cognitive examination fee is the same fee (in U.S. dollars) as required for all U.S. candidates, plus any international surcharge or site
fee established by PearsonVue. The Psychomotor examination fees are established by the NREMT on a case-by case basis and must be prepaid.
National Registry Representatives may be appointed who are residents of foreign countries after appropriate training and only with authorization by the NREMT.
All applicants must meet current NREMT entry requirements.
All refreshers, continuing education, cardiac resuscitation courses that can be utilized for NREMT continuous certification must be
approved by the Continuing Education Coordinator Board for EMS.