The Emergency Medical Services Exemplary Service Medal is the newest member of the Exemplary Service Medals Family. It was created on July 7th, 1994 to recognize professionals in the provision of prehospital emergency medical services who have performed their duties in an exemplary manner, characterized by good conduct, industry and efficiency. They must have been employed with EMS on or after October 31st, 1991 and have completed twenty years of exemplary service, including at least ten years in the performance of duties involving potential risk.

Nominations for the medal are submitted by the Provincial Awards Committee to the National Advisory Committee which reviews the eligibility of the nominees and, if acceptable, submits the applications to the Chancellery, the branch of the Office of the Governor General responsible for the administration of honors. The Chancellery then submits the nominations to the Governor General for his/her approval.