[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-361847-105":59,"doc-detail-361847-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","emt-skills-competency-verification-complete-packet","EMT Skills Competency Verification - Complete Packet","","EMT Skills Competency Verification form packet designed for validating an EMT’s demonstrated competence for renewal or reinstatement. The document contains sections for certification holder information and signatures from both the EMT and an approved verifier, including verifier identity, approval source, and license/certification details. It lists ten evaluated skills such as trauma assessment, medical assessment, BVM ventilation, oxygen administration, AED-assisted cardiac arrest management, hemorrhage control, spinal motion restriction, penetrating chest injury, and administration of epinephrine and naloxone, plus childbirth and neonatal resuscitation, followed by completion instructions and scenario-based scoring guidance for patient assessment and trauma management.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":20,"@type":76,"position":81},"https://docshare.wps.com/document/exam/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/emt-skills-competency-verification-complete-packet/361847/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/emt-skills-competency-verification-complete-packet/361847.png","ImageObject",300,407,{"name":92,"@type":93},"WPS_1786070896","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",18,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Who must complete the EMT section of the skills verification form?","Question",{"text":113,"@type":114},"The EMT whose skills are being verified must fill out the EMT section, certifying they performed the listed skills before an approved verifier and were found competent.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What does the approved verifier confirm when completing the verification section?",{"text":118,"@type":114},"The approved verifier certifies through direct observation that the listed EMT is competent in each skill, and records verifier identity, approval source, and license/certification information.",{"name":120,"@type":111,"acceptedAnswer":121},"How long is the skills competency verification valid for EMT renewal or reinstatement?",{"text":122,"@type":114},"Skills competency verification is accepted for EMT renewal or reinstatement for a maximum of two (2) years from the date of skill verification.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},361847,1790241391,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":19,"category_name":20,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":36,"preview_page_count":4},549768072016,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","(01/17)  \nSee attached for instructions for completion  \nThis section is to be filled out by the EMT whose skills are being verified:  \nI certify that I have performed the below listed skills before an approved verifier and have been found competent to perform these skills in the field.  \n\n| Name as shown on California EMT Certificate | EMT Certificate Number | Signature |\n| --- | --- | --- |\n\nThis section is to be filled out by an approved Verifier (see instructions for information on approved Verifiers) . By filling out this section the Verifier certifies that they have, through direct observation, verified that the above EMT is competent in the skills below.  \nSkill Verified Verifiers Information  \n\n| 1. Trauma Assessment\u003Cbr>(Signature of Verification) | Name of Verifier: | Date of Verification: |\n| --- | --- | --- |\n|  | Approval to Verify from: | Cert./License Info. of Verifier: |\n| 2. Medical Assessment\u003Cbr>(Signature of Verification) | Name of Verifier: | Date of Verification: |\n|  | Approval to Verify from: | Cert./License Info. of Verifier: |\n| 3. Bag-Valve-Mask Ventilation\u003Cbr>(Signature of Verification) | Name of Verifier: | Date of Verification: |\n|  | Approval to Verify from: | Cert./License Info. of Verifier: |\n| 4. Oxygen Administration\u003Cbr>(Signature of Verification) | Name of Verifier: | Date of Verification: |\n|  | Approval to Verify from: | Cert./License Info. of Verifier: |\n| 5. Cardiac Arrest Management w/ AED\u003Cbr>(Signature of Verification) | Name of Verifier: | Date of Verification: |\n|  | Approval to Verify from: | Cert./License Info. of Verifier: |\n| 6. Hemorrhage Control & Shock Management\u003Cbr>(Signature of Verification) | Name of Verifier: | Date of Verification: |\n|  | Approval to Verify from: | Cert./License Info. of Verifier: |\n| 7. Spinal Motion Restriction-Supine & Seated\u003Cbr>(Signature of Verification) | Name of Verifier: | Date of Verification: |\n|  | Approval to Verify from: | Cert./License Info. of Verifier: |\n| 8. Penetrating Chest Injury\u003Cbr>(Signature of Verification) | Name of Verifier: | Date of Verification: |\n|  | Approval to Verify from: | Cert./License Info. of Verifier: |\n| 9. Epinephrine & Naloxone\u003Cbr>Administration\u003Cbr>(Signature of Verification) | Name of Verifier: | Date of Verification: |\n|  | Approval to Verify from: | Cert./License Info. of Verifier: |\n| 10. Childbirth & Neonatal Resuscitation\u003Cbr>(Signature of Verification) | Name of Verifier: | Date of Verification: |\n|  | Approval to Verify from: | Cert./License Info. of Verifier: |\n\nINSTRUCTIONS FOR COMPLETION OF EMT SKILLS COMPETENCY VERIFICATION FORM  \n1. A completed EMT Skills Verification Form (EMSA-SCV 01/17) is required for those individuals who are either renewing or reinstating their EMT certification. This verification form must accompany the application.  \n2. Verification of skills competency shall be accepted as valid to apply for EMT renewal or reinstatement for a maximum of two (2) years from the date of skill verification.  \n3. The EMT that is being skills tested shall provide their complete name as shown on their California EMT certification, the EMT certificate number and signature in the spaces provided.  \n4. Verification of Competency  \nOnce skills competency has been demonstrated by direct observation of an actual or simulated patient contact, i.e. skills station, the individual verifying competency shall:  \na. Sign the EMT Skills Competency Verification Form for that skill.  \nb. Print their name on the EMT Skills Competency Verification Form for that skill.  \nc. Enter the date that the individual demonstrated the competency of the skill.  \nd. Provide the name of the organization that has approved them to verify skills.  \ne. Provide their certification or license type and number.  \n5. In order to be an approved skills verifier you must meet the following qualifications:  \na. Be currently licensed or certified as an EMT, AEMT, Paramedic, Registered Nurse, Physician Assistant, or Physician, and  \nb. Be approved t","cbCaicXZrRvx1BMH","https://ap.wps.com/l/cbCaicXZrRvx1BMH","pdf",2222472,16,"English","# Instructions for Completion of EMT Skills Competency Verification Form\n# EMT and Verifier Certification Sections\n# Skill Verification Items (1-10)\n# National Registry EMT Psychomotor Examination\n## Patient Assessment/Management - Trauma\n## Candidate, Examiner, Date, Signature and Scenario","[{\"question\":\"Who must complete the EMT section of the skills verification form?\",\"answer\":\"The EMT whose skills are being verified must fill out the EMT section, certifying they performed the listed skills before an approved verifier and were found competent.\"},{\"question\":\"What does the approved verifier confirm when completing the verification section?\",\"answer\":\"The approved verifier certifies through direct observation that the listed EMT is competent in each skill, and records verifier identity, approval source, and license/certification information.\"},{\"question\":\"How long is the skills competency verification valid for EMT renewal or reinstatement?\",\"answer\":\"Skills competency verification is accepted for EMT renewal or reinstatement for a maximum of two (2) years from the date of skill verification.\"}]","EMT Skills Competency Verification - Complete Packet | PDF",1790145798]