Candidates receive two full attempts at the Advanced Level Psychomotor Examination. All individual skills must be passed within the two full attempts. If one full attempt is failed, candidates must successfully pass all of the necessary skills for their respective level even if they successfully passed those skills in the previous full attempt. The necessary skills for each level can be found here.

Within each full attempt, qualifying candidates may have the opportunity to retest individual skills up to two times. The conditions which result in failure of one full attempt at the Advanced Level Psychomotor Examination for each level are listed below.

Failure of one full attempt at the AEMT level consists of either:

  • Failure of five (5) or more skills
  • Failure of any second retest opportunity

Failure of one full attempt at the Paramedic level consists of either:

  • Failure of four (4) or more skills
  • Failure of any second retest opportunity

After a failure of the first full attempt, candidates are required to provide proof of remediation of the skills needed for their respective level. The instructor, program director, training officer, or medical director who conducted the remediation can send a remediation letter to Should a candidate fail the second full attempt of the psychomotor examination, the candidate must complete a new accredited education program.



The first and last names printed on the candidates identification must match exactly the first and last names on their Psychomotor Authorization to Test (PATT). 


The steps below are required to submit a name change request:

  1. Login to your NREMT account 
  2. Select "Settings" in the right corner of your account 
  3. Select "Edit NREMT Profile Information" 
  4. Under "Personal Information" select the blue link labeled "Name Change" 
  5. Select "Simple Name Change" if you need to correct spelling or add your middle initial OR Select "Significant Name Change" if you are adding to or changing your name
  6. Enter your name change information and upload your supporting documentation
  7. Select "Save" once completed and please allow 3 business days for processing


When candidates arrive at the examination site, they will be required to present one form of acceptable identification. Candidates who cannot provide proper identification at the test center will be turned away and required to reregister and pay another exam fee.

All forms of identification must be valid and meet the following requirements:

  • Government-issued
  • Non-expired
  • Name (in Roman characters)
  • Recent photograph
  • Signature

Examples of acceptable forms of identification:

  • Passport books and cards
  • Driver’s license
  • State or Territorial identification card
  • Permanent residence card
  • Military identification card
All National Registry examination materials are copyrighted.
  • Candidates are not permitted to disclose or discuss with anyone, including instructors, information about the examination questions or answers seen during their examination. (This includes posting or discussing questions on the internet and social media websites).
  • Reconstructing exam items using their memory of their exam or the memory of others is prohibited
  • Candidates are not permitted to seek help from anyone in answering examination 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 emailing
Late arrivals to a psychomotor exam are permitted at the discretion of the National Registry Representative and the Examination Coordinator at the examination site.

Extenuating circumstances, such as inclement weather conditions, may be considered. If admitted into the examination, candidates arriving late must be allowed to complete the entire portion of the psychomotor examination needed.

No candidate may be permitted to complete only a portion of the psychomotor examination. If the facility cannot ensure that the candidate will complete all portions of the psychomotor examination, the candidate must be dismissed from the examination and instructed to make arrangements to complete the examination at a later date.

Candidates who are listed as a no-show will have their Psychomotor Authorization to Test (PATT) locked to the examination until it is processed at the National Registry office. PATT numbers cannot be released early once the examination date has passed. If a candidate knows they will not be present for an examination, they can remove their PATT from the roster.
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. Examination fees for candidates dismissed from a test center will not be refunded. Additionally, examination results may be withheld or canceled. The National Registry 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.), 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; or
  • Creating a disturbance of any kind.
EMR and EMT Psychomotor Authorizations to Test (PATT) for National EMS Certification will be valid for up to 24 months from the date of issuance, provided all other requirements for National EMS Certification are met. Candidates who do not complete their psychomotor examination prior to the expiration date will be required to complete a new EMS education course and submit a new application. No refunds will be issued for expired PATTs.

Candidates may file an official complaint with the National Registry Representative for any reason during the administration of an Advanced Level Psychomotor Examination. Some common examples may include, but are not limited to: 

  • Harassment/Discrimination 
  • Equipment malfunction 
  • Examiner conduct/behavior 

Complaints filed after the unofficial results have been reported to the candidate will not be accepted or considered. All complaints must be filed, investigated, and resolved prior to the candidate receiving unofficial results.

EMR and EMT psychomotor examinations are not administered by the National Registry. All EMR and EMT psychomotor exams are administered by either the State EMS Office or at the training institution (with approval and oversight provided by the State EMS Office). Contact your instructor or State EMS Office about the format and logistics of completing a state-approved EMR and EMT psychomotor exam.