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Form PH-0130 Medical Statement for Emergency Medical Services Professional License - Tennessee
What Is Form PH-0130?
This is a legal form that was released by the Tennessee Department of Health - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is a Form PH-0130?
A: Form PH-0130 is a Medical Statement for Emergency Medical Services Professional License in Tennessee.
Q: What is the purpose of Form PH-0130?
A: The purpose of Form PH-0130 is to provide medical information for the assessment of an applicant's fitness to hold an Emergency Medical Services Professional License in Tennessee.
Q: Who needs to fill out Form PH-0130?
A: Anyone applying for an Emergency Medical Services Professional License in Tennessee needs to fill out Form PH-0130.
Q: What information is required on Form PH-0130?
A: Form PH-0130 requires personal information, medical history, and a statement of medical fitness from a licensed healthcare professional.
Q: Are there any fees associated with Form PH-0130?
A: There may be fees associated with the processing of Form PH-0130. Contact the licensing board for more information.
Q: Is Form PH-0130 specific to Tennessee?
A: Yes, Form PH-0130 is specific to Tennessee and is used for the assessment of fitness for an Emergency Medical Services Professional License in the state.
Q: How should Form PH-0130 be submitted?
A: Completed Form PH-0130 should be submitted according to the instructions provided by the licensing board or the Tennessee Department of Health.
Form Details:
- Released on December 1, 2019;
- The latest edition provided by the Tennessee Department of Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form PH-0130 by clicking the link below or browse more documents and templates provided by the Tennessee Department of Health.
