Get Voluntary Ambulance Inspection Program - Maryland State Archives

This guide provides clear and supportive instructions for completing the Voluntary Ambulance Inspection Program form online. It is designed to help users navigate the important steps involved in the application process and ensure all necessary information is accurately submitted.

Follow the steps to successfully complete your application.

1. Press the ‘Get Form’ button to access the application form and open it in your preferred editing tool.
2. In the application, fill in the date of application and date application received at the top of the form.
3. Indicate the number of vehicles to be inspected by checking the corresponding boxes for Ambulance - BLS, Ambulance - ALS, First Response - BLS, and Chase Car/Engine - ALS.
4. Complete the section titled 'Name of Organization,' providing the official name and principal physical address of your entity, including street address, city, state, and zip code.
5. Provide contact information by entering the principal contact person’s name, title, office phone, and home phone in the designated fields.
6. Specify the type of service your organization provides by checking either ‘Volunteer’ or ‘Career’.
7. List the organizational officers, their titles, and levels of EMS certification, ensuring each officer's information is accurate.
8. Attach a copy of the vehicle inspection certificate for each ambulance or vehicle being listed, dated within the past 12 months.
9. Confirm insurance by attaching a copy of the policy if applicable to the ambulance or medical service, or check the box if self-insured.
10. Complete the membership information section, listing personnel and their respective health care certifications.
11. Finalizing your application, ensure that the signatures of authorized individuals are affixed and confirm the accuracy of all provided information.
12. After filling out the form, save your changes, and you may download, print, or share the completed application as needed.

Begin your application now by accessing the form and following the outlined steps!