EMS Agency Application Package

The documents, information and forms on this page are for use by persons interested in becoming licensed as an Emergency Medical Service (EMS) agency and for entities that wish to renew their EMS agency license. All required forms must be accurate and complete prior to submission to the local Office of EMS Program Representative.  The Office of EMS Program Representative in your area is the primary contact if you have additional questions or require further information. In addition, please feel free to contact the Office of EMS at 1-800-523-6019 and speak with a representative from the Division of Regulation and Compliance staff.

Vehicle Checklist

Air Medical Checklist

EMS Agency Application

Program Representative Information

Regional Council Contact Information

OMD Information

Vehicle Liability Requirements

Approve EVOC Course Memorandum

Pre-Hospital Patient Care

IRS Tax Exempt Letter – Sample (missing)

Regulations Governing EMS 2012