How to Become an EMT in Tennessee

Who can apply

• You must be at least 18 years old.
• You must be able to read, write and speak English.
• You must have a high school diploma or GED.
• You must have no history in the past three years of habitual intoxication or drug misuse that affects your ability to practice.
• You must submit a medical exam on the Board's form (PH-0130) showing you are physically fit for patient care.
• You must complete a criminal background check through the state-approved vendor.

Step by step

1. Complete an EMS Board-approved EMT course.
2. Pass the Board-approved practical (skills) exam.
3. Pass the Board-approved written exam.
4. Apply online at lars.tn.gov (or on paper form PH-2397) and pay the $50 application fee and $75 license fee.
5. Submit the medical statement, high school verification, notarized declaration of citizenship and statement of licensure level.
6. Complete the criminal background check through the state vendor.
7. Finish every licensing step within two years of course completion, or the application is treated as abandoned.

Official application →

Training and exam

Training: You must complete an EMT course approved by the Tennessee EMS Board. The Board approves all schools that train EMTs under EMS Rule 1200-12-01-.13. Instructors must sign that you finished all didactic, lab, clinical and field work under national (NHTSA) education standards. The state does not list a separate hour minimum.

Exam: Tennessee rules require you to pass both a Board-approved written exam and a Board-approved practical exam for EMT. The practical uses the state's EMT skills sheets (for example Medical and Assessment PH-4457 and Trauma and Assessment PH-4458). If you fail, you may reapply for the exam. All licensing requirements must be finished within two years of completing training. The state refers applicants to the National Registry (NREMT) for written exam information; NREMT charges $104 per EMT exam attempt.

What it costs in Tennessee

Fixed amounts are set by the state. Items marked “your quote” are priced by private sellers, so enter what you’re quoted.

Keeping your certification

Renewal: The standard renewal cycle is 24 months; your first cycle may be 12 to 36 months, with CE prorated. To renew, pay the $65 fee, show a current CPR card (AHA BLS for Healthcare Providers or equivalent), and meet one of: 20 Board-approved CE hours (13 cardiac/medical/trauma, 5 pediatric, 2 preparatory), acceptable college credit hours, or the National Registry assessment exam. At least half of CE must be classroom (CAPCE F5 counts). Do not send CE records unless audited, and keep them for four years. You can renew online up to 60 days before expiration.

Good to know in Tennessee

Moving from another state: Apply by reciprocity at lars.tn.gov. You need a current license in another state and must hold or have held NREMT certification at the EMT level. The fee is $100 and a background check is required. Tennessee does not issue temporary licenses.

Out-of-state EMTs working here: For EMTs working in Tennessee under an EMS Compact privilege to practice, a September 2024 Board policy requiring a Tennessee license within 180 days was withdrawn in December 2024. The Board now strongly encourages, but does not require, getting a Tennessee license by reciprocity within 180 calendar days, and ambulance services must report such workers within 30 business days.

EMS Compact: Tennessee is a member of the EMS Personnel Licensure Interstate Compact (REPLICA), Tenn. Code Ann. 68-140-601, which gives EMTs licensed in other member states a privilege to practice.

Two-year time limit: If you do not finish all licensing steps within two years after your course, the application is considered abandoned and destroyed.

Lapsed license: You may not work as an EMT with an expired license. You can renew within 60 days after expiration by paying a monthly late penalty (capped at twice the renewal fee). After that you must apply for reinstatement ($100): within one year you must also pass a Board renewal written exam; one to two years, written and practical exams; more than two years, repeat the full EMT course and initial requirements (Rule 1200-12-01-.04(4)).

Sources

• TDH - Emergency Medical Services Board
• TDH - Initial License for Emergency Medical Technician
• TDH - EMS Professional Application/Fees (PH-2397)
• TDH - Renewal and CE Information
• TDH - Reciprocity Requirements for EMS Professional License (Rev. 5-2025)
• TDH - EMT Student Folder Checklist (PH-3944)
• TN EMS Board policy - Out-of-state licensees (2024)
• Tenn. Comp. R. & Regs. 1200-12-01-.04 (Cornell LII)
• NREMT - EMT Candidate Handbook, Certification Process
• Tennessee EMS Board approved minutes, Dec 11, 2024
• EMS Compact Commission - Tennessee