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Wisconsin Department of Health Services

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Name Change and Address Update Information

Name Change

Since First Responder certification and EMT licensure are professional credentials, name changes must be verified before changes are made. Name changes are made through written request to the following address:

          WI EMS Unit Name Change
          1 W Wilson St, Room 1150
          PO Box 2659
          Madison, WI 53701-2659

In your letter please include the following:

  • Current name

  • Current EMS license or certification number

  • Name you wish to have on your new license or certification

  • Current address, phone number, and e-mail address

Along with the above letter please enclose within the envelope:

  • A self-addressed stamped envelope

  • Legal documentation of your name change

Legal documentation can be any of the following:

  • Certified copy of a birth certificate

  • Certified copy of your marriage certificate

  • Certified copy of a divorce decree

  • Certified copy of court documents that note your legal name change

In Wisconsin you can obtain your certified documents through the Wisconsin Vital Records Services.

All certified copies of legal documents are considered your personal property, they will be returned to you in the requested self-addressed, stamped envelope.

Name change questions should be sent to:

dhsemssmail@wisconsin.gov

Address Information 

It is the responsibility of the certificate/license holder to keep address information current with the EMS office.  Renewal notices and other important information will be sent to you at the address (and/or e-mail address) on file. Under DHS 110.16 (C)  there is a $30 fee for returned renewal notices.  Mail sent by the Wisconsin EMS Unit is not forwarded with a forwarding order through the post office.  It is returned to the EMS office. 

Address information must be kept current through your Wisconsin E-Licensing account.

Last Revised: February 04, 2014