You may also be interested in the Cognitive Exam Information or the How To Apply For A Cognitive Exam page.
Plan to arrive at the testing center at least 30 minutes before your exam. If you are more than 30 minutes late you may have to re-register and pay another exam fee. If you are not able to take your exam on the scheduled date or time, you must notify Pearson VUE (online or via a phone call) at least 24 hours prior to your scheduled time. A "no show" will result in forfeiture of your exam payment.


  • If there are extenuating circumstances for missing your scheduled exam, you may elect to appeal the "No Show" designation.
  • All appeals are considered, but those that fall outside the following list are typically not approved:
    1. Medical emergencies for candidate or candidate's immediate family
    2. Death of immediate family member
    3. Called into work – EMS PERSONNEL ONLY
    4. County or statewide weather/natural disaster emergency
  • Submit a signed personal statement to National Registry that contains:
    1. First and last name
    2. Mailing address
    3. Telephone number
    4. National Registry candidate number
    5. Date of scheduled exam
    6. Location of exam
    7. Explanation for missing scheduled exam
  • You must also submit supporting documentation that includes:
    1. Medical provider's note with date of incident and/or medical records with date of incident
    2. Obituary or other documentation of death
    3. Work orders or documentation from supervisor on letterhead with supervisor's signature
    4. Weather or county report at time of scheduled exam.
  • Send your personal statement and supporting documentation to
  • You will be contacted by mail within 30 days with a decision
Download a PDF of this policy

After successful completion of an approved EMS education program, candidates are initially given three attempts to pass the cognitive examination (provided all other requirements for National EMS Certification are met). If a candidate is unsuccessful on an exam attempt, they may apply to retest 15 days after the last examination. After three unsuccessful examination attempts, EMT, AEMT, and Paramedic candidates must submit official documentation verifying the completion of a remedial training program.

Remedial Training Requirement

Remedial training is designed to provide candidates additional education and to improve their performance on subsequent examination attempts. After a remedial training program is complete, the candidate is given additional attempts to pass the examination (provided all other requirements for National EMS Certification are met). Candidates who fail to pass the cognitive exam after a total of six attempts attempts are required to complete an entire state approved education program.

Certification Level Hours of Remedial Training
EMR Not applicable. EMRs must repeat a full education program
EMT 24 hours, or completion of the National Component of the NCCP model.
AEMT 36 hours, or completion of the National Component of the NCCP model.
Paramedic 48 hours, or completion of the National Component of the NCCP model.

Authorizations to Test (ATT) for National EMS Certification will be valid for up to 90 days from the date of issuance, provided all other requirements for National EMS Certification are met. Candidates who do not complete their cognitive examination prior to the expiration date will be required to complete a new application, including payment of the application fee. No refunds will be issued for expired Authorizations to Test.

Effective: January 1, 2015
Announced: December 11, 2013

Download a PDF of this policy.

Any candidate who questions the accuracy of the cognitive examination results may request that his/her examination be reviewed by the National Registry. Requests must be made in writing within thirty (30) days of the notification of examination result and must be accompanied by a check or money order for the appropriate fee to cover the processing and handling of the review. The review fee is refunded in the unlikely event that an error is discovered. The review will take place within thirty (30) days of the payment being processed. You will receive a report after the requested review is completed.

The National Registry offers candidates two types of review: A CBT Exam Scoring Confirmation Report and an Item-by-Item Review.

CBT Exam Scoring Confirmation Report

 The CBT Exam Scoring Confirmation Report includes the following information about your exam:
  • Total time used for the exam
  • Minimum and maximum time on scored items
  • Total number of items delivered
  • Number of items correct
  • Number of items incorrect
  • Number of un-scored items (Includes Pilot Items, Non-Disclosure Statement, etc.)
  • A summary of the percent correct and incorrect by the time spent on items
  • Verification of the performance (above passing, near passing, and below passing)
Processing and handling fee: $75.00

Item-by-Item Review

Candidates may request a detailed review of each examination item delivered. An item-by-item review is recommended if a candidate believes that they received outdated content or duplicate items. Item-by-Item reviews include an analysis of every exam item by a qualified staff member of the National Registry who is knowledgeable in the delivery of out-of-hospital care. When requesting an item-by-item review, you must specifically state the reason for the review. The review will include only those items relevant to your specific allegation.You will also receive a CBT Exam Scoring Confirmation Report included in this review.

Processing and handling fee: $150.00


The first and last names printed on your identification must match exactly the first and last names on your Authorization to Test (ATT).


When you arrive at the test center, you will be required to present two forms of valid, unexpired identification. One must be a government-issued ID that includes a signature and permanently affixed photo (visible signature not required for millitary IDs).The second ID must include your name and signature.

If the ID does not meet these requirements, you will be turned away and required to reregister and pay another examination fee. Acceptable Identification

Acceptable Government issued ID:
  • State Issued Driver's License
    Temporary/paper IDs will not be accepted
  • State Issued Identification Card
  • Millitary Identification Card
  • Passport

Acceptable Government issued ID:
  • U.S. Social Security Card
  • Bank ATM / Debit or Credit Card
All National Registry cognitive examination materials are copyrighted.
  • Candidates are not permitted to disclose or discuss with anyone, including instructors, information about the exam questions or answers seen in your examination. (This includes posting or discussing questions on the Internet and social media websites).
  • Reconstructing exam items using your memory of your exam or the memory of others is prohibited.
  • Candidates are not permitted to seek help from anyone in answering exam questions.
  • Candidates are not permitted to remove examination materials or notes about the examination from the testing center.
Note: If you witness any of the above behavior, or any irregular behavior that may be in violation of the National Registry Candidate Policies, report it to the National Registry immediately by calling 614-888-4484.
A candidate who violates National Registry policies, or the test center's regulations or rules, or engages in irregular behavior, misconduct and/or does not follow the test administrator's warning to discontinue inappropriate behavior may be dismissed from the test center. Exam fees for candidates dismissed from a test center will not be refunded. Additionally, your exam results may be withheld or canceled. The National Registry of EMTs may take other disciplinary action such as denial of National EMS Certification and/or disqualification from future National Registry exams. Behaviors that are considered to constitute irregular behavior or misconduct include but are not limited to:
  • Giving or receiving assistance of any kind during an exam.
  • Using, accessing, or attempting to access any prohibited items. Prohibited items are any devices or materials that will be helpful in taking the National Registry exam. Examples of aids that are prohibited include electronic devices (e.g. cell/mobile/smart phones, tablets, smart watches, etc.), hand-held calculators, conversion tables, dictionaries, etc.
  • Attempting to take the examination for someone else.
  • Accessing or attempting to access such study materials at any time after the start of the examination administration
  • Failing to follow testing regulations or the instructions of the test administrator.
  • Creating a disturbance of any kind.
  • Tampering with the operation of the computer or attempting to use it for any function other than taking the examination.