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 7119 Rev. 2023/01/18