You may also be interested in the Cognitive Exam Information or the How To Apply For A Cognitive Exam page.

Testing Center

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.


On the day of your examination, be sure to log on to OnVUE no more than 30 minutes prior to your scheduled appointment time. Logging in earlier may cause connectivity issues.  You may cancel or reschedule your examination at any time before your scheduled test time if you are unable to test. 


  • 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 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.

The National Registry is committed to a fair and unbiased testing process and follows industry best practices to ensure that all examinations are accurately scored. As a service to the community, the National Registry offers candidates the option to have their examinations rescored by a qualified staff member. Although it is extremely unlikely an examination was incorrectly scored, the rescoring process allows verification of a score.

If a candidate suspects that their score may have been negatively affected by a specific item, or items, delivered on their written examination, they may ask for a review of such item(s) as part of their rescoring request. Only items identified in the request will be reviewed. For example, if a candidate suspects that an item asking to interpret a 12-lead ECG was outside the scope of practice for the certification level at which they tested, they must indicate that in their rescoring request. If such items were present on their examination, they will be reviewed to ensure (1) their accuracy, (2) whether they were within the scope of practice for the relevant certification level, and (3) whether they had any impact on the test score.

The rescoring process is not:

  • A review of the content of all items administered during the examination
  • A reconsideration of the passing standard or the acceptability of the testing conditions
  • An opportunity for the candidate to review examination items

How to Request a Review of the Scoring Report

To request a review of the scoring report, please complete the Rescoring Request Form detailing the specific reason for the request. Requests must be submitted within 30 days of the official release of the cognitive examination score reports.

A $150.00 fee is due prior to the rescoring process. Once a rescore request is received, The National Registry of Emergency Medical Technicians will e-mail a payment request to the candidate that will include a link to make a payment via credit card.

Once payment is submitted and confirmed, the National Registry will rescore the examination and, if requested, conduct a review of items identified in the rescoring request. The review will take place within 30 days of receipt of payment.

Upon completion of the rescoring process, candidates will be provided with a Rescoring Report similar with the one included below as a sample. If an irregularity is discovered during the review process, the review fee will be refunded, and we will work with the candidate on further accommodations and resolutions.

Click here to complete the Rescoring Request Form.



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

Acceptable Second 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.