Apply for an ambulance service license

If you are applying for an ambulance service license for the first time, you must complete all parts of the application. The Office of Emergency Medical Services (OEMS) must receive your complete application and all required fees before your application can be reviewed.
 
To apply for a new an ambulance service license, download and complete the entire Ambulance Service License Application (All Parts).

You may also access each application part individually:

• Part A: Ambulance Service License Application
• Part B-1 and B-2: Ambulance Service Area
• Part C: Ambulance EMS Personnel List
• Part D: Ambulance Service Place of Business
• Part E: Ambulance Vehicle Certification
• Part F: Ambulance Affiliation Agreement Review Checklist, 9/2010

Initial applicants must submit the following:

• A Notice of Intent (enclosed in application)
• Letter of endorsement from highest elected/appointed municipal official (for municipal applicants)
• A Certificate of Good Standing for the applicant from the Secretary of State’s office from the state in which the corporate headquarters are located (for private and corporate applicants)
• A Certificate of Good Standing from the Department of Revenue of the state in which the applicant resides or the corporate office is based (for private and corporate applicants)
• A list of all officers, directors, shareholders and operation managers of the applicant
• A current copy of the Articles of Organization of the applicant
• Other information that is deemed necessary pursuant to the Department’s review of the submitted material