Certification FAQs

red line break


1.     How do I claim my account on the County's licensing website?

  • To claim your account on Image Trend, go to cosd.imagetrendlicense.com and click forgot username.
  • Enter your credentials: 
    • date of birth
    • SSN
    • email address 
  • If you are still unable to claim your account, please give the office a call at (619) 285-6429 and a member from the Credentialing Unit will help you. 
  • If you are brand new to the County of San Diego, you will need to create an account.

2.     Can I mail in my application or bring it to the office?

All applications are submitted and processed online. Go to cosd.imagetrendlicense.com to complete the appropriate application, submit the requested documents, and pay the fees. When this has been completed, your application will appear in the queue for processing.

3.     I lost my EMT card – how do I get it replaced? 

If you have misplaced your state EMT card, have a name change and need a new one, or never received your card in the mail, login into your ImageTrend account and complete the Request for Replacement Card application. Your request will be processed, a new card will be printed and mailed to the address in your application.

4.     Why didn’t my application get processed?

This could be for a number of reasons:

  • Did you remember to complete the check-out process? If not, your application will not appear in the queue for processing. 
  • Did all the documents you uploaded meet all of the necessary criteria? If not, you should have received an email from a Credentialing Unit staff member requesting additional information. 
  • Were there any criminal or license-related discipline disclosures? If this is the case, you may be contacted directly by a member of the Investigation Team.

5.     How do I upload documents after I already submitted my application?

  • When you are logged in to your LEMSIS account, you will click on the “My Account” tab. 
  • Click on the “Application” tab, then the "Review" tab. 
  • Navigate to your recent application, and select "Start" on the associated Additional Document Upload from.

6.     How long will it take to get my card?

Your EMT state card will be sent to the address that you provided on your application. EMSA will mail your EMT state card within at least 4 weeks minimum. In the meantime, you will be able to check your state status at emsverification.emsa.ca.gov.

7.     What if I move or change my name?

Regulations require you to inform your certifying EMS office of any address or name change within 30 days. Log into your ImageTrend account and complete a Change of Information – Personnel form.

8.     I passed the NREMT and I am now a “Nationally Registered EMT.” Can I start work as an EMT within the County of San Diego or are there other requirements?

The NREMT is the cognitive (written) and psychomotor (skills) exam used to qualify EMTs for certification in the State of California.  Once you have passed the exams and received your EMT National Registry certificate, you will need to complete the steps outlined for an Initial EMT within the County of San Diego.

9.     Who needs to take the NREMT computer-based exam?

There are four occasions when someone would take the NREMT computer-based exam:

  1. When you have completed an EMT course
  2. When your EMT card has been expired for more than one year
  3. When you are coming into California from another state and have not taken the NREMT exam
  4. If you want to have an NREMT card so you can list the certification on job applications and/or resumes Information regarding NREMT may be found at www.nremt.org or by calling 614.888.4484

10.   Do I need to maintain my NREMT card?

Whether you maintain/renew your NREMT eligibility is up to you. There is no California requirement to maintain NREMT once you are California EMT certified. NREMT eligibility renewal requirements are located at NREMT.ORG and are independent of the California EMT certification process.


EMT Initial Certification:

1.     How do I become an Emergency Medical Technician (EMT) within the County of San Diego?

To become an EMT within the County of San Diego, you will need to successfully complete an EMT course. Each course has requirements, which can include a background check and a current CPR card. A list of approved San Diego County EMT programs can be found here.

Once you have successfully completed an EMT course, you must apply for certification in California. If you live in or plan to work in San Diego County, you should apply for certification with the County of San Diego.

The County of San Diego EMS office requires the following documents:

  • To complete a Live Scan using this form
  • Complete the application
  • Upload the requested documents

                 - Government-issued photo identification

                 - EMT course completion certificate

                 - Current NREMT card

                 - Current card CPR (BLS/Healthcare Provider/Professional Rescuer-level)

  • Pay the fees. A Credentialing Unit staff member will review your application and inform you of the next step(s).

2.     When can I apply for my EMT card?

After completing an EMT course and passing the NREMT exam, you have two years (from the date on the course completion certificate) to apply for EMT certification.

3.     What if I have an EMT certificate from another state?

Regardless if you are EMT certified in another state, you need to be currently registered by the NREMT and complete the process for initial California EMT certification.

4.     Can I challenge the EMT exam?

Individuals from out-of-state can challenge the EMT exam only if they are a currently licensed physician, registered nurse, physician assistant, vocational nurse, an EMT-P, or have documented evidence of successfully completing an EMT training program of the Armed Forces.

5.     How much does a Live Scan cost and where can I get one?

The cost of Live Scans varies depending on where you go to get one. You can use a search engine (i.e. Google, Yahoo) to shop around for Live Scan agencies. San Diego County EMS Agency cannot perform Live Scans.

6.      Can I do a Live Scan outside of California?

The electronic Live Scan process cannot be completed outside of California. The California DOJ allows for the hand-rolling of fingerprints for those outside of California. The Request for Exemption from Mandatory Electronic Fingerprint Submission Requirement form and FBI/U.S. DOJ Fingerprint form FD258 are to be used to submit your fingerprints. There are several steps to complete the process:

  • Complete the applicant section of the Fingerprint form FD-258. For reason, use: EMTcertification.
  • Take the Fingerprint form FD-258 to an agency/company to have your fingerprints rolled.
  • Complete the Request for Exemption form.
  • Send the two forms back to the DOJ's address at the top of the form with a money order in the amount of $51.00, made payable to the California Department of Justice.
  •  An applicant can contact the EMS office (619-285-6429) to request the paper fingerprint form and exemption form. These will have to be completed and returned with payment to the DOJ for processing.

7.     I recently did a Live Scan for my job, can I use that one for San Diego County EMS.

You will need to complete a Live Scan specifically for the San Diego County EMS Agency as the Department of Justice and FBI information cannot be shared among agencies.

8.     I have a criminal history; can I become an EMT?

Any positive history will be investigated. The applicant must submit a copy of the final court docket of then conviction(s) and a letter of explanation providing us with the details of the case. Additional materials that may be submitted include:

  • letters of recommendation from current and past employers or instructors, and / or letters about the applicant's character. 
  • If you have a positive conviction history, we advise you to do your background check as soon as possible. 
  • There are certain criminal convictions for which EMT certification will NEVER be granted to applicants, see information in the following question. 
  • There are other convictions which require applicants to wait up to ten (10) years before applying for an EMT certification. 
  • State statute requires applying for EMT certification within two (2) years of completing the EMT Training Course; you should consider whether to take an EMT course with a criminal background – recognizing your certification may be delayed or denied.

9.    What criminal convictions will prevent me from becoming an EMT?

Preclusion criteria under state regulations are:

  • Has committed any sexually related offense specified under Section 290 of the Penal Code.
  • Has been convicted of murder, attempted murder, or murder for hire.
  • Has been convicted of two (2) or more felonies.
  • Is on parole or probation for any felony.
  • Has been convicted and released from incarceration for the said offense during the preceding fifteen (15) years for the crime of manslaughter or involuntary manslaughter.
  • Has been convicted and released from incarceration for the said offense during the preceding ten (10) years for any offense punishable as a felony.
  • Has been convicted of two (2) or more misdemeanors within the preceding five (5) years for any offense relating to the use, sale, possession, or transportation of narcotics or addictive or dangerous drugs.
  • Has been convicted of two (2) or more misdemeanors within the preceding five (5) years for any offense relating to force, threat, violence, or intimidation.
  • Has been convicted within the preceding five (5) years of any theft-related misdemeanor.

10.   What if I fail to disclose a past incident or conviction on my EMT Application?

Failure to disclose your involvement in a current investigation or criminal charges; or any conviction for a misdemeanor or felony offense in California or in any other state or place, including entering a plea of nolo contendere or no contest, including any conviction which has been expunged (set aside) under Penal Code 1203.4 is considered FRAUD in the procurement of a certificate. This may result in disciplinary action and denial of your certificate.

Any incident or conviction in your past must be disclosed each time you apply for certification. It is your responsibility to provide the verified court records/documents and a detailed statement (explanation).

In addition, you must disclose if you had a certification, accreditation, or professional healing arts license denied, suspended, revoked, or placed on probation; or if you are currently under formal investigation or disciplinary action. Again, it is the EMT's responsibility to disclose, provide the necessary documentation, and a written explanation of facts that describes the action and/or remediation.

11.   What happens if I have subsequent arrest and /or conviction after a negative LiveScan report?

The EMS Agency and the EMS Authority receive DOJ subsequent arrest notifications within forty-eight (48) hours of any arrest in California.  Depending upon the seriousness of the arrest, the EMS Agency may take disciplinary action against your EMT certificate. The action may include suspension and/or revocation. It is best to advise the EMS Agency and your EMS Employer (if EMT employed) if you are arrested before the Agency receives the Live Scan subsequent arrest notification.


EMT Renewal:

1.     When can I submit my renewal application?

It is a good idea to turn your materials in at least 60 days before your expiration date. We do not quote turnaround times, but the state mandates that your application be processed within 45 days of a completed application being received.  Your recertification application package can be submitted up to six months in advance of your card expiring. Your new expiration date will be two years from the current expiration date; unless your card has expired in which case it will be two years from the issue date

2.     What are the basic renewal requirements?

Every two years you must complete 24-hours of continuing education or a 24-hour Refresher class, maintain a current CPR card (BLS/Healthcare Provider/Professional Rescuer-level) and complete a skills verification.

3.     What will I need to submit with my application?

  • A completed online EMT Renewal application (cosd.imagetrendlicense.com
  • A copy of a photo ID: current driver's license, ID card, or valid military ID card
  • A copy of your 24 hours of continuing educations certificates
  • A copy of your skills verification test form.
  • A copy of your current CPR card.

4.     What portion of my CE requirements need to be Instructor  Based?

 At least half of the twenty-four (24) hours of Continuing Education must be in an ‘Instructor Based’ format and cover topics in the US DOT Education Standards.

5.     Can I use my AHA Healthcare Provider CPR Certification for CE credits?

A CPR card is not a CE certificate. You may receive a CPR card as part of an approved EMS CE course.  The number of CE hours for the course is determined by the EMS CE provider; a CE certificate for your CPR training is needed if you plan to use these hours towards your renewal.

6.     I am in paramedic school. Does that count?

If you are a student in a paramedic class or have been in the past two years, the school may give you a letter that can be used for CE. The letter typically identifies you as a paramedic student and tells how far along in the course you are and what curriculum has been completed. If you are in paramedic school, ask your school for such a letter. You still have to complete the skills verification testing.

7.     Where can I take continuing education or refresher courses?

Continuing education and refresher courses for recertification can be taken anywhere; they do not have to be done in San Diego County. They must, however, be offered from an approved EMS program.  If CE classes are taken from an out-of-state provider, the provider must be CECBEMS/CAPCE approved OR approved by another state's EMS authority.

8.     When do I need to verify my EMT skills?

  • Done at the end of your EMT training course (Initial Certification)
  • Part of your twenty-four (24) hour EMT Refresher Class (Renewal)
  • When you renew your EMT Verification (every two years) and elect not to complete an EMT Refresher Class

9.     How do I document that I have completed my Skills Verification?

Complete the State of California EMT Skills Competency Form (Skills Verification Form). This completed form is valid for two (2) years from the date of verification.

10.   Who can certify my EMT skills/competency?

  • Qualified individuals that are:
    • licensed or certified as an EMT; AEMT; Paramedic; Registered Nurse;    Physician Assistant; or Physician in California 
    • AND 
    • designated by an approved EMS Provider to verify EMT skills.
  • Designated individual(s) of an approved EMT or Paramedic Training Program.
  • Designated individual(s) of an approved EMS CE Provider.

11.   Can my field training officer certify my EMT skills?

Although your field training officer may be a seasoned EMT or paramedic, he/she must also be designated for skills verification by an approved EMS Provider.

12.   Can I have my supervisor, relative, or co-worker verify my skills?

Section 1.C of Skills Competency Verification Form requires your signature and verifies the information you provided is accurate, and you demonstrated your skills to a qualified individual. It is your responsibility to confirm the individual(s) verifying your skills meets the criteria for certifying your EMT skills (i.e., qualified AND designated). Section 1.D of the Form reflects the approved EMS Provider (Certifying Authority) that designates the individual(s) verifying your skills.

13.   I heard that naloxone, epinephrine autoinjectors, and glucometer training is now required for EMTs in California.  What is the timeframe for obtaining this training? Where do I get information?

        Starting 7/1/2019, an EMT renewing his or her certification for the first time shall submit documentation of         successful completion of the following training by an approved EMT training program or approved CE         provider:

14.   When my application with the County of San Diego is completed, will I have to submit an application directly to the State of California to complete the state certification?

No, once the application you submit to the County of San Diego has been reviewed and the certification,  renewal, or reinstatement is processed, the County of San Diego will issue the State EMT card as well.

15.   My certification is about to expire… Can I apply for an extension?

There are no extensions, waivers, or exceptions.

16.   What happens if my EMT certification expires?

You may not work, perform, or represent yourself as an EMT after your certification expires. There are no extensions, waivers, or exceptions. You should submit your renewal application, fee, and materials to the  EMS Agency at least sixty (60) days prior to certification expiration. It is your professional responsibility to maintain your certification.

17.   What happens if my EMT certification has lapsed, is there a grace period?

  • There are no grace periods. EMT certifications are good for two years from the date issued. Lapsed certifications requirements are outlined below:
  • For lapses of less than 6 months
    • 24 hours of CE or a 24 hour approved refresher course
    • EMT Skills Competency form
    •  A new Live Scan background check is required if you are changing certifying entities (ex. from Orange County EMS to San Diego County EMS).
  • For lapses of 6 months to less than 12 months
    • 36 hours of CE 
      • May combine an approved 24 hour refresher course and 12 additional CE hours
    • EMT Skills Competency form
    • A new Live Scan background check is required if you are changing certifying entities.
  • For lapses of 12 months or more
    • 48 hours of CE
      • Many applicants combine an approved 24 hour refresher course AND 24 addition CE hours
    • EMT Skills Competency form
    • A new Live Scan background check
    • Current NREMT OR other licensure:
      • Current NREMT EMT, AEMT, or Paramedic certificate 
      • OR 
      • current California AEMT certificate or Paramedic license.
  • Apply for reinstatement at a local EMS agency.

18.   I am a paramedic and I wish to get my expired EMT certificate reinstated – what do I need to do?

Depending on the expiration date of your EMT certificate, requirements vary.  Please see the section above on lapsed EMT certification requirements. Your paramedic license is separate from the EMT certification and is not used to reinstate an EMT certificate automatically. 

19.   I have been overseas deployed on active duty and my EMT certification has expired. What can I do?

A California certified EMT who is a member of the Armed Forces of the United States and whose certification expires while deployed on active duty, or whose certification expires less than six (6) months from the date they return from active duty deployment, with the Armed Forces of the United States shall have six (6) months from the date they return from active duty deployment to complete the renewal requirements found on the EMT page. Verification of the individual’s active duty is required. Also, for certified individuals whose military duty required them to use their EMT or AEMT skills, credit may be given for documented training they received while on active duty if it meets CA state continuing education requirements. These individuals would need to provide documentation from their Commanding Officer(s) attesting to classes attended and successful completion. 


EMT Transfer:

1.     What if I want to change certifying entities mid-cycle – what is required? 

Should you wish to change certifying entities due to employment requirements (though the state EMT card is valid throughout CA), you may do so.  You will need to meet the renewal requirements of 24 CEs, skills verification, and a background check is always required when changing certifying entities.  You will maintain the same E# and your 2-year cycle will depend on whether you are within 6 months of your current expiration or re-certifying greater than 6 months in advance.  You will need to complete the EMT Renewal and Transfer application at https://cosd.imagetrendlicense.com. Once your application has been processed, you will need to schedule an appointment for an in-person verification and ID check.

2.     At the time of my renewal, can I transfer to a different certifying entity?

Yes, see the paragraph above, the requirements are the same.


EMT Out of County Status:

 1.     I am certified by another certifying entity in the state of California and am current, but I want to work within the County of San Diego, do I need to re-certify with the County of San Diego?

No, as long as you are current with the State of California, you may work within the County of San Diego. Go to https://cosd.imagetrendlicense.com and complete the EMT Out of County Registration Form and upload the requested documents. Once reviewed, you may be issued Out of County status to match the current expiration of your state EMT card.


AEMT County of San Diego:

1.     What is the difference between an EMT and AEMT?

The difference is an AEMT is a California certified EMT with additional training in limited advanced life support (LALS).

2.     Where can I work as an AEMT in San Diego County?

The only entity in San Diego County that hires AEMTs is the US Border Patrol (USBP).

3.     How do I become certified as an AEMT in San Diego County?

To be eligible for certification as an AEMT in San Diego County you must meet the following criteria:

  • Possess a current EMT certification in the State of California
  • AEMT Course completion record from approved AEMT Training program (Not to be over 1 yr old)
    • If you completed your AEMT course outside San Diego County, you must submit 6-hour Paramedic Accreditation Workshop from Palomar College.
  • Have valid NREMT-AEMT card
  • Submit a Live Scan criminal background check for the County of San Diego
  • Have a current CPR card
  • Submit the EMT and AEMT Initial Application

5.     What are the renewal recertification requirements?

Every two years you must complete at least 36 hours of continuing education, maintain a current CPR card (BLS/Healthcare Provider/Professional Rescuer-level), complete an Advanced EMT Skills Competency Form, and pay the fee.



1.     When and why do I need paramedic accreditation?

The California Emergency Medical Services Authority licenses paramedics. In order to work as a paramedic in the County of San Diego, you must be accredited by the County of San Diego EMS.

2.     What does local accreditation involve?

Accreditation to practice as a paramedic in the County of San Diego is granted upon successful completion of the following:

  • Provide evidence of a valid California Paramedic License.
  • Provide documentation of training and competency in the local optional and expanded scope of practice 
    • If your Paramedic Training did not occur within the County of San Diego, you may be issued a 90-day Provisional accreditation, during which time you must attend the local 6 hr training program to receive full accreditation to work within the County of San Diego.
  • Provide a copy of your current ACLS card.
  • Provide a copy of your current government-issued photo ID.
  • Complete the online application.

3.     How long is the accreditation good for?

Your accreditation will be in effect for the length of your current California paramedic license certification cycle or 2 years if you accredited mid-license cycle.

4.     Can Paramedic 90-day Provisional license be extended or renewed?

The 90-day Provisional status cannot be extended or renewed. Provisional status shall be allowed only once for a Paramedic in a lifetime.

5.     As a paramedic, do I need an EMT card?

No, an individual who is currently licensed as a paramedic in California is considered to be a certified EMT without additional testing (except when a paramedic’s license is under suspension) and may work within the County of San Diego in this capacity. However, you will need to login to the LEMSIS, create an account (if you do not already have one) and complete the application for OTHER HEALTHCARE PROFESSIONAL and choose the option of “Paramedic working at the BLS level”

6.     If I am renewing my accreditation with the County of San Diego, what documents will I need?

  • Provide evidence of a valid California.
  • Provide a copy of your current government-issued photo ID.
  • Provide a copy of your current ACLS card.
  • Complete the online application.