N.H. Code Admin. R. Saf-C 5904.02 – Provider License Application

(a) Each applicant for a provider license shall complete and submit “New Hampshire Bureau of EMS Provider License Application” form, https://www.nh.gov/safety/divisions/fstems/documents/providerlicenseapplication.pdf, as revised May 2021.
(b) The application shall be signed and dated by:
1. (1) The applicant;
2. (2) When applicable, the primary EMS service's head of unit or his/her designee to certify that the applicant is affiliated with the licensed unit; and
3. (3) In the case of an apprentice, a parent or legal guardian.

Source. (See Revision Note #1 and Revision Note #2 at Chapter heading for Saf-C 5900) #12790, effective 5-24-19; ss by #13174, eff 2-24-21; (see also Revision Note at part heading for Saf-C 5904)