Licensure

Licensure Documents

  1. Ambulance Licensure Overview (PDF)
  2. BLS Optional Equipment
  3. EMS Accident Report Form (PDF)
  4. EMS Agency Service Medical Directors Form (PDF)
  5. Approved & Required Medications for Emergency Medical Services - 09/25/2021
  6. Extended Expiration Dates for Medications (PDF)
  7. How to Obtain a CLIA Certificate of Waiver (PDF)
  8. PA EMS Approved Medication List-Sept 25, 2021 (PDF)
  9. Pediatric Voluntary Recognition Program (PVRP) (PDF)
  10. Pennsylvania Approved NEMSIS v3.4 PCR Vendors (PDF)
  11. PVRP - Information Sheet (PDF)
  12. Required Equipment (All levels) - 09/11/2021
  13. Temporary Vehicle Use Form (PDF)

Inspection Forms

  1. 09-01-2019 BLS Ambulance Inspection Checklist (PDF)
  2. 09-01-2019 BLS Squad Inspection Checklist (PDF)
  3. 09-01-2019 IALS Ambulance Inspection Checklist (PDF)
  4. 09-12-2019 IALS Squad Inspection Checklist (PDF)
  5. 09-01-2019 ALS Ambulance Inspection Checklist (PDF)
  6. 09-01-2019 ALS Squad (Responder) Inspection Checklist (PDF)
  7. 09-01-2019 CCT Ambulance Inspection Checklist (PDF)
  8. 09-12-2019 QRS Inspection Checklist (PDF)
  9. 07-01-2016 Station Policy Checklist - (Applies to All Levels) (PDF)
  10. 09-01-2017 Reserve Ambulance Inspection Checklist (PDF)

Licensure Job Aids

  1. Creating an Administrator Account for Non-EMS Certified Persons (PDF)
  2. Creating Your New EMS Agency Application (PDF)
  3. Finding your EMS System Organization or Creating a new EMS System Organization (PDF)
  4. Renewal or Amendment EMS Agency Licensure Application (PDF)

Voluntary Rescue Service Recognition Program

  1. 2008 VRSR - Application (PDF)
  2. 2009 VRSR - General Administration Documents (PDF)
  3. 2009 VRSR - Personnel Roster and Instructions (PDF)
  4. 2009 VRSR - Vehicle and Machinery (PDF)
  5. 2009 VRSR - Vehicle Information Page (PDF)
  6. 2009 VRSR - Water Rescue (PDF)