Promoting and protecting the health and safety of all Idahoans Idaho.gov   Contact Us  
Department of Health and Welfare   Search
Provider Licensure Forms

 

Provider Licensure Forms

These forms are in PDF format. Click on the form you need, print, complete, and return to the Idaho EMS Bureau.
Address: PO Box 83720
Boise, ID 83720-0036
Fax: 208-334-4015
 
Initial Provider License
 
Initial Provider Application (use for Initial and Reversion) 

Renewal Application with Guide
 
 
Miscellaneous Forms
 
 
Idaho Accessibility   Privacy & Security   About Us   Contact Us  
Copyright 2007 by Idaho Department of Health and Welfare Idaho