Are you a provider newly hired by one of our Partner Agencies?
Or an independent provider looking to practice under your license within the System?
All HP EMS System providers must complete the System Entry requirements. Please contact us if you are unsure about your status.
The HP EMS System is transitioning to a new data management system. All EMS System Providers MUST complete the data collection form that is associated with their discipline.
Note: You only need to complete this form once, and only for the appropriate licensure.
Scan or tap the form for your discipline:
All HP EMS System providers are individually responsible for the maintenance of their license(s). Note that lapses in licensing coverage can impact your authorization to practice within the System. Please contact us if you have questions about the renewal process.
If you have had a change of information, please help keep the System up to date by completing this form.