The IEMSR does not discriminate against anyone wishing certification from the IEMSR. The student must have completed an approved course in EMT, EMT-I, or Paramedic based from the U.S. DOT curriculum. The instruction must have been provided by an experienced EMS Instructor that holds Instructorships in at least two EMS related courses and was conducted at a training facility. The course must be accepted by the country where the course takes place. A letter from the proper authority must show acceptance of the course and that the IEMSR is an accepted certification for each participant.

The IEMSR Executive Board and Board holds the right to determine validity and acceptance of the course. All decisions from the board are final. Testing must be initiated within 30 days of course completion. If a participants fails, a re-test will be offered at another test site. The IEMSR is not responsible for site location nor dates the test is provided. A participant must complete the written and practical exam to be awarded certification and the participant must complete the testing requirements within 12 months. The application fee to the IEMSR is Forty U.S. dollars per application request. If the participants fails to complete the testing within 12 months, a new course must be taken before the participant can gain re-entry to IEMSR testing. The site for testing must have proper equipment and facilities for testing.

The Test Site Coordinator is responsible for all testing materials for the skill station. The written exam is the sole property and responsibility of IEMSR. A board member or authorized proctor from the IEMSR must be present at the test site. Expense for travel, lodging, food, etc. are the responsibility of the test site and must be paid for in advance. The Test Site may charge a site fee to each participant to cover such expenses. All other expenses incurred by the Test Site are the responsibility of the Test Site. The participants must pass with a 70% or higher for EMT and EMT-I. Those taking the Paramedic exam must pass with an 80% or higher. All practical exams must be completed as well. All certifications are valid for two years. IEMSR reserves the right to add or delete testing requirements at any time.