Sub-Section 3-630-88 - Community Paramedic Academy Terminal Competency Form

Citizens Memorial Hospital - Emergency Medical Services Education Department hereby certifies that the candidate listed below has successfully completed all the terminal competencies required for graduation from the Community Paramedic education program as a minimally competent, entry-level Paramedic and as such is eligible for Missouri State licensure in accordance with our published policies and procedures.

Name of graduate:

• Overall score: % (80% minimum overall score). [PROOF ATTACHED (OzarksEMS Transcript)]
• Total contact hours: (100 minimum hours: 60 classroom/laboratory + 40 clinical [as requried by MO 19 CSR 30-40.800(2)(A)]). [PROOF ATTACHED (OzarksEMS Transcript)]
• Practical skill sheets (includes all required skill sheets).
• Clinical tracking records (includes required hours, areas, procedures, patient contacts, etc.):
• All clinical and experience hours meet minimum requirements. [PROOF ATTACHED (OzarksEMS)]
• Laboratory and clinical skill meet minimum requirements.
• Student counseling (as applicable). Notes:
• Required course certifications:
• NAEMT GEMS. [PROOF ATTACHED]
• NAEMT CPC. [PROOF ATTACHED]
• Final exams:
• Cognitive: Final exam with at least 70% score on one of two possible attempts.[PROOF ATTACHED (JBLearning)]
• Affective: Final comprehensive eval with "PASS" status. [PROOF ATTACHED (Google Drive)]
• Medical Director interview (if applicable).

Program requirements successfully and fully completed on:

Program Director signature:

Medical Director signature (optional):