Community Paramedic (EMS) Pre-Registration Screening Form

This form serves as a Pre-Registration Screening for the CNM Community Paramedic Program (EMS).

Need Help?

If you have any questions about this form, please call (505) 224-4111 or email before submitting.

Before Submitting This Form

  1. Please read the screening criteria and guidelines for the Coordinated Entry Programs.
  2. Please read the instructions for the Community Paramedic (EMS) Pre-Registration Screening Form.

You cannot "save" your work and return to it later.

Submission of your form does not guarantee you a seat in the program. Screening forms will not be considered for students who have not been admitted to CNM.

Screening Term of Entry   Which term are screening for entry to begin the Community Paramedic program?

Information and Acknowledgements

For each of the following statements click the box to acknowledge you understand that you have met/will meet the following requirements. If you have any questions on any of these statements, please contact (505) 224-4111 or email before submitting this form.


When you click "submit" a screen will appear that will notify you that your form was submitted successfully. You will also receive an email confirmation to your CNM email account.