Get Application For Ambulance Service - City Of Mcallen

The Application For Ambulance Service - City Of McAllen is a crucial document required for operating ambulance services within the city limits. This guide provides a user-friendly approach to completing the application online, ensuring that all necessary information is accurately submitted.

Follow the steps to complete your application online easily.

1. Click the ‘Get Form’ button to access the application form and open it in your preferred document editor.
2. Begin by entering the Company License Number and Expiration Date at the top of the form. Ensure that these details are accurate and up-to-date.
3. In the 'Company & Owner Information' section, input the required details: DSHS State License Number, Company Name, Physical Address, Mailing Address, Phone Numbers, and Fax Number. Double-check for accuracy and completeness.
4. Provide the Owner's information including their name, address, driver’s license number, phone number, and email address.
5. Describe the vehicles that will be used for ambulance services. For each vehicle, provide details such as City of McAllen Permit Number, Description of Ambulance Type, Ambulance Number, Vehicle Year, Make, Model, VIN Number, and License Plate Number.
6. Indicate the highest level designation for each vehicle (BLS, ALS, or MICU) ensuring that original DSHS certificates will be available at the time of inspection.
7. In the Medical Equipment & Documents section, ensure you have a copy of your signed Minimum Supply List, DSHS Provider Application, and Protocol Book submitted in a single PDF format.
8. Provide a copy of your Biohazards contract, ensuring that it has the current valid date or shows terms for contract duration.
9. Attach an Excel spreadsheet listing all personnel information, including each employee's name, birth date, driver’s license number, and DSHS certification.
10. Lastly, attach a copy of every insurance policy or proof of financial responsibility as specified, and ensure that the City of McAllen is listed as the Certificate Holder.
11. Sign and date the application, confirming you understand the reporting requirements for any changes in the information provided.
12. Once you have completed the application, you can save your changes, download the document, print it, or share it as required for submission.

Complete your application for ambulance service online to ensure compliance and smooth operation.