Notice of First Responder Training Program and
Instructor Qualifications
Instructions: Mail or fax to the attention of Rickey Stone, Bureau of Emergency Medical Services, 4052 Bald
Cypress Way, Bin C18; Tallahassee, FL 32399-1738 or fax sheet to (850) 245-4378 or (850) 245-4440 Extension
*2753.
Date:
First Responder Training Facility:
Lead Instructor:
Address:
County:
Phone:
Email address:
Fax:
1995 US DOT NSC
First Responder Training Course Standards:
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Course content outline meets or exceeds the 1995 US DOT
First Responder (NSC).
The CPR component meets or exceeds that provided by the
American Heart Association CPR Basic Life Support (BLS)
course “C,” or American Red Cross CPR BLS for Professional
Rescuer, or its equivalent as defined by the department rule.
Primary and Assistant Instructors must be knowledgeable in all
aspects of out-of-hospital emergency medical care, in the
techniques and methods of adult education and the managing
of resources and personnel. (EMT or Paramedic)
Medical Director The Program’s Medical Director must be
knowledgeable of state EMS rules, EMS system configuration,
national standards of care, and educational principles.
Keep Training Program Records of: (1) Student attendance
and performance at each lesson. (2) Grades for each written
examination and completed checklist for each skill evaluation.
(3) Name of Instructors and their qualifications.
Documentation of successful course completion to include: (1)
Date of Issuance, (2) Student Name, (3) Name of Training
Program, (4) Instructor’s Printed Name and Signature.
A comprehensive written and practical examination is
standard requirement for the course. [National Registry First
Responder Certification is available to your agency. Call
(614) 888-4484 for information.
A method for students to evaluate instructors after each course.
Florida Statutes
401.435 First responder agencies and training.
(1) The department must adopt by rule the United States
Department of Transportation Emergency Medical Services: First
Responder Training Course as the minimum standard for first
responder training. In addition, the department must adopt rules
establishing minimum first responder instructor qualifications. For
purposes of this section, a first responder includes any individual
who receives training to render initial care to an ill or injured
person, other than an individual trained and certified pursuant to s.
943.1395(1), but who does not have the primary responsibility of
treating and transporting ill or injured persons.
(2) Each first responder agency must take all reasonable efforts to
enter into a memorandum of understanding with the emergency
medical services licensee within whose territory the agency
operates in order to coordinate emergency services at an emergency
scene. The department must provide a model memorandum of
understanding for this purpose. The memorandum of understanding
should include dispatch protocols, the roles and responsibilities of
first responder personnel at an emergency scene, and the
documentation required for patient care rendered. For purposes of
this section, the term "first responder agency" includes a law
enforcement agency, a fire service agency not licensed under this
part, a lifeguard agency, and a volunteer organization that renders,
as part of its routine functions, on-scene patient care before
emergency medical technicians or paramedics arrive.
History: s. 24, ch. 92-78; s. 11, ch. 95-408.
Note: Model MOUs are available on request by calling Rickey
Stone at (850) 245-4440, extension 2753.
FIRST REPSONDER PROGRAM STANDARDS:
Submit the following:
 Documentation to show the course content meets or exceeds that provided in the 1995 U.S. DOT EMS First Responder
Training Course Guide.
(Attach as attachment 1)
 Documentation to show the CPR component meets or exceeds that provided by the American Heart Association CPR Basic
Life Support (BLS) course “C”, or American Red Cross BLS for the Professional Rescuer, or its equivalent as defined by
department rule.
(Attach as attachment 2)
 Documentation to show the Training Program’s medical director is knowledgeable of state EMS rules, EMS system
configuration, national standards of care, and educational principles.
(Attach as attachment 3)
 Documentation to show students are required to pass a comprehensive written and practical examination.
(Attach as attachment 4)
 Documentation to show students evaluate the instructor after each course.
(Attach as attachment 5)
 Instructor’s CV or resume.
(Attach as attachment 6)
 How does the training plan to keep records of successful course completers.
(Attach as attachment 7)
Certification Statement
The undersigned representative(s) of the above program, do hereby certify the training program meets or exceeds all
standards for a First Responder Training Program as referenced in this document and as provided in chapter 401.435, FS,.
______________________________________________
Name of Program Director/Coordinator
_______________________
Date
______________________________________________
Name of Person Completing the Application
_______________________
Date
_______________________
Telephone Number
Send completed to:
Attn: Rickey Stone
Bureau of Emergency Medical Services
4052 Bald Cypress Way Bin C18
Tallahassee, FL 32399-1738
Telephone: (850) 245-4440 extension 2753
FAX: (850) 245-4378
e-mail: rickey_stone@doh.state.fl.us