How to become an EMT in Missouri

Missouri licenses EMTs through the Department of Health and Senior Services' Bureau of EMS, and it issues a first license only to people with current National Registry certification. Everything below comes from the Bureau's licensing page and Missouri statute 190.142, checked October 18, 2026. Confirm on the linked pages before you pay.

Study aid, not a protocol. Nothing on this site replaces your course, your medical director or your agency's protocols. Built by an RN and former EMT. Headed In LLC is not affiliated with, endorsed by or connected to the National Registry of Emergency Medical Technicians (NREMT) or any state EMS office; their names appear here only to point you to the real thing.

The national steps, briefly

  1. A state-approved EMT course

    Every state approves its own programs, all taught to the National EMS Education Standards. Most run 150 to 300 hours over three to six months.

  2. A healthcare-provider CPR card

    AHA BLS or an equivalent your state accepts, usually before clinicals.

  3. The cognitive exam

    The National Registry (NREMT) EMT exam: 70 to 120 adaptive questions in 2 hours, $104 per attempt, six attempts within two years of your course.

  4. Your state's license or certification

    The card comes from the state, not the Registry. The state's own steps are below.

The full national walk-through: How to become an EMT.

Missouri, step by step

Missouri Department of Health and Senior Services, Bureau of EMS

  1. Course and exam: an EMT course, then current National Registry certification at the EMT level, which you prove with the application.
  2. Fingerprints first: a Missouri State Highway Patrol and FBI fingerprint check through an IdentoGO location, transmitted to the Bureau before you apply; you pay the fee and can track it by its TCN. No license issues until the results arrive.
  3. Application: the Personnel License Initial Application in the Bureau's online licensing system. You must speak, read and write English. No license fee appears on the Bureau's page; ask your program.
  4. Age: set by rule, not on the Bureau's page; ask your program.
  5. License: good for five years.
  6. Relicensing: 100 hours of continuing education and a current CPR card, applied for 30 to 120 days before the license expires.
  7. From another state: licenses from other states cannot be transferred; see the Bureau's reciprocity page.

Sources: Missouri Bureau of EMS, EMT and paramedic licensing; RSMo 190.142 (five-year license, background check). Checked October 18, 2026.

Practice for the exam, freeOur own questions, written to the national standards and tagged to the exam's 28 job tasks, with a Pass Meter.

Official pages