All incoming Kitsap providers should provide the following form and supporting documents to the KCEMS office. Please contact  [email protected] or at 360.447.2068 to ensure the form has arrived.

Once the form has been received by the KCEMS office, the provider will receive notice of their core training enrollments.

Already have a Target Account
Level of Certification
WA Credential
Primary District
If you have a WA credential number put it here.
Before your DOH application is signed off, you must pass the protocol test.
Protocol test
What date do you want to take the protocol test?

All providers practicing in Kitsap County must complete their level of core training.  When onboarding, please attach to this form, any of the following documentation. 

Travis Law
Choose File
Choose File
Choose File
SGA Endorsement
Choose File
Current CPR Card
For your appropriate level.
Choose File
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