Letter of Review (LoR)

The CoAEMSP has the Letter of Review (LoR) process, which is the official designation that a Paramedic program is in the ‘Becoming Accredited’ process.

The CoAEMSP Letter of Review (LoR) Application process has been revised.  All program sponsors seeking a CoAEMSP Letter of Review will be required to follow the revised LoR process according to CoAEMSP Policy I.A. Seeking Accreditation – Letter of Review (LoR) Process effective January 1, 2021. Please visit the Policies and Procedures page of the website to review CoAEMSP Policy I.A., as well as, all policies in their entirety.  All required forms are available on the Self-Study Reports page or the Resource Library page.  A few key requirements of the revised process include:

  • Submission of an LoR Application Invoice form [new]
  • Submission of an LoR Application [new] and payment of all fees
  • Workshop attendance by the CoAEMSP approved Program Director [new]
  • Submission of a completed/approved Letter of Review Self Study Report (LSSR) [revised 11/2020]
  • Preliminary site visit [new]

While the program can begin work on the LSSR at any point, it will not be accepted until submission/approval of an LoR Application, payment of all applicable fees, and workshop attendance has been verified.  If the Program Director hired by the sponsor has attended an Accreditation Workshop within the last twelve (12) months, that information can be verified by CoAEMSP.

After a program receives the LoR, the program will complete the Initial Accreditation Self Study Report (ISSR). The ISSR is due no later than six (6) months after graduation of that class of students that was first enrolled after the date of issue of the LoR. The program will submit along with the ISSR the evaluation fee and the site visit flat fee (see Fees page. CoAEMSP will notify the program if there are exceptions to the flat site visit fee requiring additional payment). If the complete ISSR is not satisfactory, then the program will have thirty (30) days after receipt of the EA to provide additional information to address the deficiencies, otherwise, the LoR may be revoked. The LoR may also be revoked if the six (6) month submission deadline is not met.

Once the ISSR is satisfactory, a site visit will be scheduled. The site visit, post-site visit Findings Letter, CoAEMSP action, and CAAHEP vote will follow the regular procedure.

Any student who graduates from a program that holds or held an LoR anytime during that student’s enrollment will be considered eligible for the NREMT Paramedic Examinations. CoAEMSP and NREMT are in close communication to maintain the list of programs holding an LoR and the students enrolled during that time.

Documents for Programs Seeking or Currently Holding the Letter of Review (LoR)


Checklist for PD of CoAEMSP LoR Programs
Mar-2021 Download
Letter of Review Programs – Preparing for the ISSR
Oct-2016 Download
LoR Application
May-2024 Download
LoR Application Invoice Request Form
Mar-2024 Download
Self-Study Report - Letter of Review (LSSR) -2023 CAAHEP Standards
Jun-2024 Download
Step By Step Instructions for Self-Study Report
Jun-2024 Download
Voluntary Withdrawal from LoR template
May-2019 Download

Publishing the Letter of Review Status of a Program

Once a Letter of Review (LoR) has been granted, CoAEMSP Policy I.B.3 contains specific wording programs must use to publish its CoAEMSP Letter of Review (LoR) status. Prior to issuing the CoAEMSP LoR, no mention of the CoAEMSP LoR or the CAAHEP accreditation process may be made by or for the Paramedic program.

In addition to the policy above, the CoAEMSP Policies and Procedures contains specific wording for LoR programs should the LoR be suspended (I.C.2) or revoked (I.C.3), as well as, once a program’s first site visit towards seeking Initial Accreditation has been scheduled (IV.A.2). The policies specifically referenced on this page (I.B., I.C., and IV.A.) can be viewed in their entirety within the CoAEMSP Policies and Procedures located here. Please keep in mind, all CAAHEP accredited programs and those seeking CAAHEP accreditation should familiarize themselves with the CoAEMSP Policies and Procedures.