Ambulance Service Licensure

The Georgia Department of Public Health Rules and Regulations Chapter 511-9-2 to license, re-license, and monitor Ambulance Services, Air Ambulance Services, Medical First Responders, and Neonatal Transport Services.

Initial License Requirements

An applicant for ambulance service licensure must submit to the Office of EMS and Trauma a complete application packet along with all other required documents and fees. Forms and additional documents can be found below. Each ambulance to be operated under the license must be inspected and approved by the department and so registered by affixing a department decal at a location specified by the department.

Forms for Initial Ambulance Services that are Corporations and LLCs ONLY

New Ambulance Service License

EMS Service License Application Packet 

Additional Supplemental Forms

Location Information - Supplemental Form A
Licensed EMS Personnel Information - Supplemental Form B
Vehicle Schedule Information - Supplemental Form C

Vehicle Inspection Forms

R-E-01-A Vehicle Inspection Form - Ground Ambulance
R-E-01-B Vehicle Inspection Form - Neonatal Ambulance
R-E-01-C Vehicle Inspection Form - Medical First Responder
R-E-01-D Vehicle Inspection Form - Air Ambulance

Forms for Initial Ambulance Services that are Governments, Authorities, and Sole Proprietors - ONLY

New Ambulance Service License 

EMS Service License Application Packet (GA EMS 1000) 

Additional Supplemental Forms

Addendum A: Insurance Information
Addendum E: Personnel Information
Addendum F: Vehicle Information
GA EMS 1000 Supplemental Form

Vehicles Inspection Forms

R-E-01-A Vehicle Inspection Form - Ground Ambulance
R-E-01-B Vehicle Inspection Form - Neonatal Ambulance
R-E-01-C Vehicle Inspection Form - Medical First Responder
R-E-01-D Vehicle Inspection Form - Air Ambulance

Service License Renewal Requirements

All ambulance service licenses must be renewed every two years. Renewal notices are mailed by the Regional Director and must be returned by the deadline with appropriate fees and application. See below for renewal applications for Corporations, LLCs, Governments, Authorities, and Sole Proprietors.

License Renewal Form for Current Ambulance Services that are Corporations and LLCs ONLY

EMS Service License Renewal Application Packet

License Renewal Form for Current Ambulance Services that are Governments, Authorities, and Sole Proprietors - ONLY

EMS Service License Renewal Application Packet (GA EMS 1000)

Revision Forms

Revision Forms for Current Ambulance Services that are Corporations and LLCs ONLY

Use the following revision forms if you are updating any locations, adding or deleting vehicles, and adding or deleting EMS personnel. 

Addition/Deletion of Base and Satellite Locations
Addition/Deletion of Ambulance Vehicles
Addition/Deletion Licensed EMS Personnel

For other revisions please use the EMS Service License Application Packet be sure to mark "Revision" on the application. 

Revision Forms for Current Ambulance Services that are Governments, Authorities, and Sole Proprietors - ONLY

Use the following revision forms if you are updating any insurance information, locations, adding or deleting vehicles, and adding or deleting EMS personnel. 

Addendum A: Insurance Information
Addendum E: Personnel Information
Addendum F: Vehicle Information
GA EMS 1000 Supplemental Form

For other revisions please complete them on the EMS Service License Application Packet (GA EMS 100) be sure to mark "Revision" on the application. 

Service Online Group Renewal

Instructions for Online Group Renewals


Yearly License Anniversary Dues

All ambulance services holding an active license must pay their anniversary dues every year with a check along with a copy of current insurance. No application is required when submitting anniversary dues.


Georgia EMS Vehicle Verification

By using Vehicle Identification Verification you are able to search for EMS vehicles information certified by Georgia Emergency Medical Services.

 

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Page last updated 3/13/2018