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Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Statewide Initiatives



211 - Get Connected. Get Answers.

 

Emergency Medical Service (EMS) Initial License Application

 Emergency Medical Transportation (EMT) service providers shall be licensed by the Department of Health and Hospitals.  DHH is the only licensing authority for EMT providers in the State of Louisiana.  It shall be unlawful to operate an EMT service without possessing a current, valid license issued by DHH.

 Initial Licensure Requirements:

  • Service area description to include map.
  • List of all ambulance stations - include complete geographical address including zip code (attachment 1).
  • List of all drivers and certified or licensed personnel (EMT, RN/LPN), including social security number, and registration or license number.
  • A list of any first responder drivers to include their social security and drivers’ license numbers.
  • List of all vehicles: Ambulances and Sprint Vehicles include VIN, make, year model, type, GVW, license plate number, unit (fender) number.
  • Certificates of Insurance:  Medical Malpractice, Automobile Liability, General Liability.  We do not accept Louisiana Automobile Insurance Identification Cards.
  • A copy of  their current medical protocols with each page signed by their medical director accompanied by a cove r letter from the appropriate parish or component medical society or societies for use in their service area.  An electronic copy may be submitted.
  • A copy of their standard operating procedures.  An electronic copy may be submitted.
  • A copy of the services current equipment and supply checklist.
  • Attach a copy of your current CLIA Waiver certificate, Louisiana CDS license, and United States Drug Enforcement Administration Controlled Substance registration.
  • Attach copies of all pertinent municipal and parish licenses and permits including Certificates of Need if they apply.
  • Attach a copy of the Articles of Incorporation.
  • Attach a copy of the Act of Sale or other Act of Transfer.
  • Payment of license fee of $150.00 plus $75.00 per vehicle (ambulance, sprint, or aircraft). The Payment Procedure has changed please follow the link for instructions.
  • Copy of the applicant’s criminal background check from the Louisiana State Police, and proof of United States or legal resident alien status from the United States Department of Homeland Security.
  • For air ambulance services only:  FAA Part 135 Certificate, FAA Aircraft Certificate of Registration*, FAA Certificate of Airworthiness*, FAA pilot’s license (for each pilot)                                     (*denotes that one is required for each aircraft)

 

The following forms will help you prepare for an inspection: