New York Department of Health. Bureau of Emergency Medical Services. Affirmation of compliance for New Vehicles or .
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How to use or fill out the Doh 1881 Fillable online
The Doh 1881 Fillable is an important document for agencies seeking compliance with New York State emergency medical service regulations. This guide provides step-by-step instructions to assist users in accurately completing the form online.
Follow the steps to fill out the Doh 1881 Fillable form effectively.
- Press the ‘Get Form’ button to access the Doh 1881 Fillable and open it for editing.
- Select the appropriate option for the type of service you are providing by checking the box next to either 'Ambulance Service' or 'ALS First Response Service'.
- Enter the 'Current Operating Certificate Expiration Date' in the designated field.
- Fill in the 'Name of Service' and 'NYS EMS Agency Code' in the respective fields.
- Complete the address section by providing the 'Address', 'City', 'State', and 'Zip'.
- Specify the 'Contact Person' along with their 'E-mail', 'Work Phone Number', and an 'Additional Phone Number' if necessary.
- Review the affirmation statement, ensuring that all listed vehicles are in compliance with the State EMS Code. This includes verifying registrations and inspections.
- Sign and date the affirmation, and fill in your name and title.
- Ensure that a Notary Public completes the required section at the bottom of the page.
- List all vehicles for agency recertification or indicate any new vehicles needing certification logos. Fill out the vehicle information, including License Plate number, Radio or Agency ID, VIN, Make, Year, Color, and Vehicle Type.
- After completing the form, save your changes. You can then download, print, or share the completed Doh 1881 Fillable as needed.
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