Agency Licensure

Below are important documents that you may need for your next agency inspection. If you have questions, need more information or resources, please contact your Regional Program Representative.

EMS Agency License – Application Instructions

EMS Agency Application – RENEWAL – Log into the EMS Portal to complete your agency application.

New EMS Agency Application – INITIAL – Complete this form to request a New EMS Agency.

     Inspection Documents:

Inspection Checklist 8-13-2022

EMS Agency Licensure Signature Page 9-26-19

Vehicle Checklist

Transport Vehicle Checklist

4″ Stripe Example for Ground Ambulance

Non-Transport Vehicle Checklist

4″ Stripe Example for Nontransport Vehicle

Neonatal Vehicle Checklist

Frequent Ambulance Marking Questions

Oxygen Cylinder Guidance

Agency Licenses and Vehicle Permits Guidance

Temporary EMS Vehicle Permit Application | Log into the EMS Portal to complete a Temporary EMS Vehicle Permit Application. | For currently certified EMS agencies adding a new emergency vehicle. Temporary permit instructions.  How to request a temporary EMS vehicle permit

Air Medical Checklist

Aeromedical Workbook Packet

Rotor Wing Vehicle Checklist

Application for EMS Air Ambulance Permit

Mutual Aid Agreement Examples:

Mutual Aid Example A (7K)

Mutual Aid Example B (4K)

Sample Templates:

Anti-Substance Abuse Program Template

Driver Eligibility Policy Template

           Sample OMD Agreement