Adirondack-Appalachian Regional Emergency Medical Services Council

Adirondack-Appalachian Regional Emergency Medical Services Council PO Box 212, Speculator, NY 12164 (518) 548-3535 Certified Lab Instructor Course # 113050 Saturday, September 28 & Sunday, September 29, 2013 SUNY, Cobleskill, NY Course Coordinator: Joyce Mulleedy

Students must complete both full days of the course plus a CLI internship in order to be certified by NYS DOH as a CLI

FOR ADMISSION INTO THE CLASS, THE CANDIDATE MUST:

 Hold current certification as a NYS EMT or AEMT  Be actively providing on-going, hands-on prehospital patient care with an EMS agency and have a minimum of one year of clinical experience within the last three years  Have scored at least an 85% on the EMT portion of their exam. NOTE: Candidates that do not have a current NYS Written Exam score may schedule themselves for an Instructor Score written exam with NYS DOH BEMS at a later date. CLI certification will not be issued without the necessary score.  Submit a letter of recommendation from a Course Sponsor that will be providing the instructor internship AND a completed “Notice of CLI Internship Plan” (attached)  Complete an Application for Instructor Certification (DOH-2260) with all of the required attachments. This application is attached .(It can also be found on-line at the NYS EMS website – Bureau of EMS Forms – EMS Education and Certification)

COURSE APPLICATIONS AND ALL REQUIRED ATTACHMENTS MUST BE SUBMITTED TO THE AAREMS REGIONAL OFFICE BY SEPTEMBER 13, 2013.

Adirondack - Appalachian Regional Emergency Medical Services Council, Inc. P.O. Box 212, Speculator, NY 12164-0212 (518) 548-3535 or 1-800-952-7367

To: All course sponsors in the region; All Prospective Students From: Joyce Mulleedy, Educational Services Coordinator Date: August 12, 2013 Subject: Certified Lab Instructor Course #113050

The region has scheduled a Certified Lab Instructor Course to be held at SUNY, Cobleskill on Saturday, Sept. 28 and Sunday, Sept. 29, 2013.

We are asking that any persons whom you have recommended to take this instructor training on behalf of your course sponsorship complete the required paperwork and submit it by September 13. These persons must:

 Hold current certification as a NYS EMT or AEMT  Be actively providing on-going, hands-on prehospital patient care with an EMS agency and have a minimum of one year of clinical experience within the last three years  Have scored at least an 85% on the EMT portion of their exam NOTE: Candidates that do not have a current NYS Written Exam score may schedule themselves for an Instructor Score written exam with NYS DOH BEMS at a later date. CLI certification will not be issued without the necessary score.  Submit a letter of recommendation from a Course Sponsor that will be providing the instructor internship AND a completed “Notice of CLI Internship Plan” (attached)  Complete an Application for Instructor Certification (DOH-2260) with all of the required attachments This application is attached .(It can also be found on-line at the NYS EMS website – Bureau of EMS Forms – EMS Education and Certification) Course applications (complete with ALL attachments) for your candidates MUST be in the regional office by September 13, 2013.

If you have any questions, please feel free to contact me at either of the above listed numbers.

ADIRONDACK-APPALACHIAN REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL, INC. P.O. Box 212 Speculator, N.Y. 12164-0212 (518) 548-3535 or (800) 952-7367 [email protected]

NOTICE OF CLI INTERNSHIP PLAN

CLI Candidate Name ______

In order to fulfill my obligation as a Certified Lab Instructor [CLI] candidate, I understand that I must serve an internship in an EMT course. The following Course Sponsor and Certified Instructor Coordinator have agreed to allow me to complete my internship in the course/s listed below.

Course Sponsor ______Supervising Certified Instructor Coordinator [CIC] ______CIC Number ______Course Type ______Course Dates ______Course Location ______Course Number (If available) ______CLI Candidate Signature ______

Date ______CIC Signature ______Date ______