{"id":232,"date":"2016-05-12T20:38:56","date_gmt":"2016-05-12T20:38:56","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/emergency-medical-services\/?page_id=232"},"modified":"2024-08-05T11:21:39","modified_gmt":"2024-08-05T15:21:39","slug":"inspections","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/emergency-medical-services\/regulations-compliance\/inspections\/","title":{"rendered":"Agency Licensure"},"content":{"rendered":"

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<\/a>.<\/p>\n

\n

EMS Agency License<\/a> – Application Instructions<\/p>\n

EMS Agency Application<\/a> – RENEWAL – Log into the EMS Portal to complete your agency application.<\/p>\n

New EMS Agency Application<\/a> – INITIAL – Complete this form to request a New EMS Agency.<\/p>\n

\u00a0 \u00a0 \u00a0Inspection Documents:<\/strong><\/h4>\n

Inspection Checklist 8-13-2022<\/a><\/p>\n

EMS Agency Licensure Signature Page 9-26-19<\/a><\/p>\n

Vehicle Checklist<\/h4>\n

Transport Vehicle Checklist<\/a><\/p>\n

4″ Stripe Example for Ground Ambulance<\/a><\/p>\n

Non-Transport Vehicle Checklist<\/a><\/p>\n

4″ Stripe Example for Nontransport Vehicle<\/a><\/p>\n

Neonatal Vehicle Checklist<\/a><\/p>\n

Frequent Ambulance Marking Questions<\/a><\/p>\n

Oxygen Cylinder Guidance<\/a><\/p>\n

Agency Licenses and Vehicle Permits Guidance<\/a><\/p>\n

Temporary EMS Vehicle Permit Application<\/a>\u00a0| 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.\u00a0 How to request a temporary EMS vehicle permit<\/a><\/p>\n

Air Medical Checklist<\/h4>\n

Aeromedical Workbook Packet<\/a><\/p>\n

Rotor Wing Vehicle Checklist<\/a><\/p>\n

Application for EMS Air Ambulance Permit<\/a><\/p>\n

Mutual Aid Agreement Examples:<\/strong><\/p>\n

Mutual Aid Example A (7K)<\/a><\/p>\n

Mutual Aid Example B (4K)<\/a><\/p>\n

Sample Templates:<\/strong><\/p>\n

Anti-Substance Abuse Program Template<\/a><\/p>\n

Driver Eligibility Policy Template<\/a><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Sample OMD Agreement<\/a><\/p>\n

\n","protected":false},"excerpt":{"rendered":"

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. 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