Get Ny Doh-206 2014-2026

The NY DOH-206 is a crucial application for obtaining an Emergency Medical Services (EMS) operating certificate in New York. This guide provides step-by-step instructions to help you complete the form efficiently and accurately online.

Follow the steps to complete the NY DOH-206 application online

1. Press the ‘Get Form’ button to obtain the NY DOH-206 application and open it in your chosen editor.
2. Fill in the name of the service in the 'Name of Service' field, ensuring accuracy as it will be used in official documentation.
3. Provide the Federal Employer ID Number in the respective field, which is essential for identification purposes.
4. Enter the NYS EMS Agency Code if applicable, as it is significant for EMS credentialing.
5. Complete the physical address of the principal business location, ensuring all fields like street, city, state, and zip code are filled out accurately.
6. Fill out the mailing address if it differs from the principal address, including the PO Box if necessary.
7. Enter the business phone number and agency email address to facilitate communication.
8. Include the fax number if available.
9. Provide the 911 Center 10-digit phone number to ensure effective emergency contact.
10. Select the organizational structure by checking only one option that best describes your service, such as commercial or fire department.
11. Indicate the type of ownership, whether it is individual, partnership, corporation, or government-related.
12. If applicable, list the names of the individual owners, partners, or government entities, along with any DBAs (Doing Business As) attached.
13. Provide the names and home addresses of current officers if your organization is a corporation.
14. Complete the section on billing for service, including the name of the service bureau if you bill for your services.
15. Fill out the section related to the highest level of care currently authorized by REMAC, selecting from the options provided.
16. List the location(s) where certified EMS response vehicles are garaged, ensuring to note the number assigned to each location.
17. Provide details about the total number of vehicles operated by the certificate holder.
18. Summarize the total employees/members, specifying numbers for volunteers and paid staff.
19. Include the number of individuals currently certified at each EMS level.
20. Complete the communications/dispatch information, including the principal dispatch method and agency dispatching your service.
21. Ensure all attachments are provided as required, including necessary certifications and compliance affirmations.
22. Certify that all the information contained in the application is true and correct by signing and dating the form.
23. Save any changes made to the form, and consider downloading, printing, or sharing it as needed.

Complete your NY DOH-206 application online now to ensure timely processing.