IEMSR is an EMR training facilitator with approvals in various states under their specific approval requirements. IEMSR is approved by the State of Louisiana for Initial and Refresher EMR training and Certification. Many states have optional approval requirements, and IEMSR will attempt to meet these requirements in any way that the rules or laws require. Alabama school boards recognize IEMSR testing as the pre-examination required for NREMT certification examination. IEMSR has applied for CAPCE accreditation for the Refresher program and will announce more upon approval. With CAPCE approval, IEMSR EMR will be accepted in various states.