The IEMSR does not discriminate against anyone wishing for certification from the IEMSR. The student must have completed an approved course in EMR, EMT, or Paramedic based on the U.S. DOT curriculum. The instruction must have been provided by an experienced EMS Instructor that holds Instructorships in at least two EMS related courses and was conducted at a training facility. The course must be accepted by the country where the course takes place. A letter from the proper authority must show acceptance of the course and that the IEMSR is an accepted certification for each participant. EMR Instructors in the state school system are to be approved by the High School in which they are employed and IEMSR.

The IEMSR Executive Board and Board holds the right to determine the validity and acceptance of the course. All decisions from the board are final. Testing must be initiated within 30 days of course completion. If a participant fails, a re-test will be offered. The IEMSR is not responsible for site location nor dates the test is provided. A participant must complete the written and practical exam to be awarded certification and the participant must complete the testing requirements within 24 months. The application fee to the IEMSR is $100 U.S. dollars per application request. If the participants fail to complete the testing within 24 months, a new course must be taken before the participant can gain re-entry to IEMSR testing. The site for testing must have proper equipment and facilities for testing. EMR exams taken in the state school system must be taken as directed by your teacher(s) at your High School.

The Test Site Coordinator is responsible for all testing materials for the skill station. The written exam is the sole property and responsibility of IEMSR. A board member or authorized proctor from the IEMSR must be present at the test site. The expense for travel, lodging, food, etc. is the responsibility of the test site and must be paid for in advance. The Test Site may charge a site fee to each participant to cover such expenses. All other expenses incurred by the Test Site are the responsibility of the Test Site. The participants must pass with 70% or higher for EMR, EMT, and Health and Safety. Those taking the Paramedic exam must pass with an 80% or higher. All practical exams must be completed in the class for EMR and EMT. Paramedic requires a skill test in addition to the written with an IEMSR Proctor present. All certifications are valid for two years. IEMSR reserves the right to add or delete testing requirements at any time.