UTHealth - Critical Care Transport

Please complete, and submit this form, AND send copies of certifications/licenses(Professional License/Certification, AHA CPR AND ACLS, Approved Trauma course (ITLS,PHTLS, etc.),  or Approved Pediatric course (PALS, PEPP,etc.)), and your check made payable to:

UTHealth
Att: CCEMTP Course Registration/Debbie Rivas
Department of Emergency Medicine
6431 Fannin
JJL 428
Houston, Texas 77030


NOTE:  Registration is not complete until check is received.


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Paramedic/RN/RT/MD License # *
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