How to become an EMT in Texas

Texas Department of State Health Services (DSHS), EMS certification

1. Who can apply: you must be at least 18 and have a high school diploma or GED.
2. Course: a DSHS-approved EMS training course. Your course completion document shows a DSHS course approval number that starts with 6.
3. Exam: the National Registry exam, which DSHS uses as the state-approved exam. You schedule it with the Registry and pay the Registry its testing fee on top of the state fee, and you may test before you send the state application. If you fail, you get chances to retake it, but there is no other route to Texas certification. Accommodation requests go to the Registry. Your Registry certification has to stay current until the last state requirement is met, and everything has to be done within two years of your course completion date, or you take another initial course.
4. Fingerprints: a Texas and FBI criminal history check. Schedule it with IdentoGO using DSHS's service code, which appears on your online application and application summary (or ask [email protected]). You pay the fingerprinting fee. If you cannot get to an IdentoGO site, call the EMS Central Unit at 512-834-6734 for a hard-copy card, which can delay results by several weeks.
5. Application: register as a new user in the DSHS online licensing system, pick the initial EMT application under the EMS board, and enter your Registry number and expiration date plus your course approval number and completion date. The fee is $64 for ECA or EMT, non-refundable and non-transferable. Processing can take up to 4 weeks, and your certificate, license and ID arrive in the secure mailbox of your DSHS online account. Volunteers who serve only with a licensed provider or registered first responder organization, and are paid by no service, are exempt from the fee.
6. Renewal: you are certified for four years from the date the certificate is issued. Renew by holding a current National Registry certification, or with 72 hours of continuing education over the four years in the state's content areas, or with a recertification course of at least 48 hours, and every renewal needs the Texas EMS jurisprudence exam. The fee is $64 within the 12 months before expiry, $94 up to 90 days late and $124 from 91 days to a year late. After a year you cannot renew and must certify again. DSHS sends no renewal notices.
7. From another state: reciprocity is open at every level to people certified out of state who are not already Texas-certified; the fee is $126.

Sources: DSHS initial certification and licensure, DSHS EMS application fees, DSHS renewals, DSHS CE hours and content areas and 25 Tex. Admin. Code 157.33 (four-year term, two-year deadline). Checked October 18, 2026.