LifeFlight / Education & Outreach / Critical Care Paramedic Application

Critical Care Paramedic Application

Application for Admission

Please note: Not all qualified applicants can be admitted to the class due to the limited number of places available.

You MUST do the following before you will be considered a candidate:

1. Fill out the online application (below) and provide a letter of recommendation / support from your employer. Submit this by email to Bo Phillips, critical care paramedic course coordinator.

2. Take the entrance exam and interview with the selection committee.

3. Verify you meet the minimum criteria (see below).

First Name: Middle: Last Name:

Address: City: State:
Zip Code:

Best Telephone Number to Reach You:

Best Email Address to Reach You:

Current Employer:

Date Hired:

Do you need accomodations due to a medical or learning disability?
If yes, please provide comment on what accommodations you will need:

Per the State of Tennessee guidelines, any student admitted into a Tennessee Critical Care Paramedic course must meet the following qualifications. Please document your qualifications and be prepared to bring copies of your license and appropraite certifications.

Each student must hold a current license as a Paramedic in Tennessee with a minimum of two years experience as an Advanced Care Provider:

Tennessee Paramedic License Number:

Paramedic License Originally Issued on What Date:

Paramedic License Expiration Date:

Must hold current certification in CPR, Advanced Cardiac Life Support, Pediatric Advanced Life Support, and an Advanced Trauma Care Course:

CPR Certification (must be Healthcare Provider or equivalent):

CPR Certification Expiration Date:

ACLS Certification Expiration Date:

PALS Certification Expiration Date:

Advanced Trauma Course Expiration Date (PHTLS or ITLS):

Applicant's Statement

I, the undersigned, apply for admission to the Critical Care Paramedic program with Vanderbilt LifeFlight. I agree that the information given on this application is true to the best of my knowledge. I realize that failure to disclose fully and accurately all facts relating to this application could be grounds for dismissal. I understand that, once accepted, it is my responsibility to familiarize myself with, and abide by, the policies, rules, and regulations of Vanderbilt University Medical Center and Vanderbilt LifeFlight. This application is made with my consent and I hereby guarantee the payment of all financial obligations incurred.

Applicant's Signature:

By entering name I agree to the above Applicant's Statement.