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EMA Licensing

Request for Practical Exam Review

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Request for Practical Exam Review

For EMA exam candidates to request a review of their practical examinations

Candidate Information

EMA Licence Number (if applicable)

Email AddressMissing or incorrect value

Last NameMissing or incorrect value

First Name(s) (full legal name)Missing or incorrect value

Requesting Review for Exam(s)

Which exams are you reqesting a review of?MedicalTraumaMissing or incorrect value

Exam Date

Missing or incorrect value

Exam LocationMissing or incorrect value

Licence Category Missing or incorrect value

1st Practical Exam Information

Examiner Name (if known)

Exam Type Missing or incorrect value

Please briefly describe the exam scenarioMissing or incorrect value

Reason for review (please describe in detail which part you would like reviewed and/or which part you disagree with)Missing or incorrect value

2nd Practical Exam Information

Examiner Name (if known)

Exam Type

Please briefly describe the exam scenario

Reason for review (please describe in detail which part you would like reviewed and/or which part you disagree with)

Personal information on this form is collected by the EMA Licensing Board under the authority of the Freedom of Information and Protection of Privacy Act Section 26(c) Emergency and Health Services Act (section 6) and the Emergency Medical Assistant Regulation (sections 2, 3, 4, 9.2, 10 and 26). This information will be used to issue an EMA licence and maintain a permanent register of licensed EMA's. If you have any questions about the collection of this information contact our office at PO Box 9625 Stn Prov Govt, Victoria B.C., V8W 9P1, phone 250 952-1211. This information is protected from unauthorized use and disclosure in accordance with the Freedom of Information and Protection of Privacy Act and may be disclosed only in accordance with that Act.

HLTH 3743 Rev. 2023/01/18

Current Date

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