Please take a few minutes to fill out the following form.
Note: Please e-mail a passport size photo (2x2) for your photo ID, a copy of your passport and your state EMT, Paramedic or Physician card to email@example.com. Include your name and Hatzalah ID # in the subject line. Please send original and do not crop a photo from a picture of an existing ID.
As always any questions: firstname.lastname@example.org