yemsa@yolocounty.org
137 N Cottonwood Street Woodland, CA 95695
530-666-8615
For RENEWING Accreditation Only
You must have documents electronically copied (cards & forms) PRIOR to starting the online application process.
Be sure to read carefully and answer all questions.
Date of Birth:
Enter your Personal Mailing Address:
I understand that I am solely responsible for notifying YEMSA in writing, within thirty (30) calendar days, of any changes to my mailing address or contact information? (A change of address form can be found on the YEMSA's website.)
Are you currently authorized/accredited in any other Agencies, Counties, or States?
If you answer YES to any of the NEXT three (3) questions, then you MUST add/attach a detailed statement.
*Note: A box will open once you click YES to add/attach statement.
1. Have you ever had a certification, accreditation, or professional healing arts license denied, suspended, revoked or placed on probation, or are you under investigation at this time? If yes, you must add/attach a detailed statement with this application that describes the action, any corrective action, and/or remediation as a result of the action.
YES, to question #1 - ATTACH a detailed Statement HERE or write it above that describes the action, any corrective action, and/or remediation as a result of the action.
2. Have you ever been convicted of any felony or misdemeanor offense in California or in any other state or place, including entering a plea of nolo contendere or no contest, and including any conviction which has been expunged (set aside) or records sealed under Penal Code § 1203.4? If yes, you must add/attach a detailed statement describing the crime(s), date, location, court, sentence served, and parole if any. You must also attach any applicable court documents and police reports.
YES, to question #2 - ATTACH a detailed Statement HERE or write it above describing the crime(s), date, location, court, sentence served, and parole if any. You must also attach any applicable court documents and police reports.
3. Are there any criminal charge(s) currently pending against you? If yes, you must add/attach a detailed statement describing the charge(s), date, location, and court, if any. You must also attach any applicable court documents and police reports.
YES, to question #3 - ATTACH a detailed Statement HERE or write it above describing the charge(s), date, location, and court, if any. You must also attach any applicable court documents and police reports.
RENEWAL ACCREDITATION "REQUIRED DOCUMENTATION"
I understand it is my responsibility to have current/valid certifications on file at all times with YEMSA. This means if a certification expires during my Paramedic Accreditation period it is my responsibility to submit a current copy to YEMSA. (Emailing a copy is the preferred method of submission)
When does your current Paramedic State License expire?
What is the status of your Paramedic State License?
ATTACH HERE a copy of your Paramedic State License Card showing expiration date.
Examples: State Driver’s License, State ID card, Military ID card, Passport.
When does your Government Issued Photo ID expire?
ATTACH HERE a copy of your Government Issued Photo ID Card showing expiration date.
When does your ACLS Certification expire?
Is your proof of ACLS Certification on a CARD or a CERTIFICATE?
ATTACH HERE a copy of your ACLS CERTIFICATE with bar code & authentication number, also showing expiration date.
ATTACH HERE a copy of the FRONT of your ACLS Certification Card showing expiration date.
ATTACH HERE a copy of the BACK of your ACLS Certification Card.
When does your PALS Certification expire?
Is your proof of PALS Certification on a CARD or a CERTIFICATE?
ATTACH HERE a copy of your PALS CERTIFICATE with bar code & authentication number, also showing expiration date.
ATTACH HERE a copy of the FRONT of your PALS Certification Card showing expiration date.
ATTACH HERE a copy of the BACK of your PALS Certification Card.
I understand that it is my responsibility to maintain confidentiality of patient medical information. In addition, I understand as an accredited Paramedic in Yolo County I am responsible to know and adhere to all of their Policies & Protocols.
When does your ITLS or PHTLS Certification expire?
Is your proof of ITLS or PHTLS Certification on a CARD or a CERTIFICATE?
ATTACH HERE a copy of your ITLS or PHTLS CERTIFICATE with bar code & authentication number, also showing expiration date.
ATTACH HERE a copy of the FRONT of your ITLS or PHTLS Certification Card showing expiration date.
ATTACH HERE a copy of the BACK of your ITLS or PHTLS Certification Card.
YEMSA will no longer requests the Infrequent or Intubation Skills Forms from your Employer. The Paramedic applicant (you) must request and upload these forms with this application process.
ATTACH HERE a copy of your INFREQUENT SKILLS Verification Form. You MUST obtain a copy from your ALS employer.
ATTACH HERE a copy of your INTUBATION Verification Form. You MUST obtain a copy from your ALS employer.
UPDATE!!! as of 5/9/19 Memo
Paramedics reaccrediting after September 31, 2019, new YEMSA reaccreditation requirements apply.
Requirements include: One (1) YEMSA ALS Update Class within a two (2) year accreditation period.
All CE's and dates are verified.
ATTACH HERE a YEMSA ALS Update Class CE Certificate.
If you need to submit any further documentation for your application please email us at: yemsa@yolocounty.org.
Be sure to include your name & phone # in the email.
A non-refundable application fee must be paid in order to process an application. Online applications can only be paid using a credit card and the card number will be encrypted for security purposes when submitted.
There is NO ($0) application fee for ON TIME Re-Accreditation applications; however, there is a $25.00 late fee for applications turned in the same month they expire (between 0-30 days).
Applications turned in the month before they are due are not considered late.
*American Express is not accepted.
Is your Application considered late?
Credit Card Billing Address:
By submitting this information, I hereby authorize YEMSA to charge my credit card in the amount noted above.
I hereby certify under penalty of perjury that all information on this application is true and correct to the best of my knowledge and belief, and I understand that any falsification or omission of material facts may cause forfeiture on my part of all rights to Paramedic accreditation in the State of California. I understand all information on this application is subject to verification, and I hereby give my express permission for this certifying entity to contact any person or agency for information related to my role and function as a Paramedic in the State of California.
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