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Agency Licensure
Life Support Agency & Vehicle Licensure
- All Vehicle and Agency Applications must be submitted thru the Image Trend Licensing System.
- All forms and publications are in PDF format unless otherwise noted. To preview and download the PDF forms, you will need Adobe Acrobat Reader. If you do not have this program, it can be downloaded from the Adobe website.
- Instructions on how to claim your ImageTrend account can be found here.
- Instructions on how to create a ImageTrend account can be found here.
- eLicensing Public Portal Userguide PDF (1.8.20)
PDF copies of licenses are available through Michigan EMS eLicensing Portal
ImageTrend Licensing Documents
- Agency Administrator Form
- Preparation for Agency Renewal Checklist
- Agency Renewal Flowchart
- ImageTrend Public Portal Userguide
Verify EMS Agency
Equipment and Agency Requirements
Items listed under MCA Approved Equipment is only required if included in MCA protocols.
The new protocol suite was released earlier this year. Medical Control Authorities have until Feb 29th to adopt them and March 31st to implement. Several MCAs have begun the adoption process with the earliest MCA implementation being December of this year. Once implemented, EMS agencies will be responsible for ensuring that the new items are stocked on their vehicles and available during inspection. During the transition time, the mandatory equipment inspection form will have requirements for both the current protocols and the newly implemented ones. Therefore, it is very important to know the specific equipment your agency will be responsible for based on protocols implemented at your MCA(s). The Department has a tracking mechanism in place, so that when your Regional Coordinator comes to conduct an inspection, they will know what new items have been implemented for your particular agency. Items “not required” will be marked as “NR” on the inspection form during inspections. Once all the MCAs in the state have implemented the new protocols, only the new protocol requirements will remain on the inspection forms.
- New Equipment Memo (1.31.24)
- Required Life Support Agency Criteria (10.15.21)
Required Ambulance Documents for Licensure
- Manufacturers Certificate of Compliance BHS/EMS-314 (Revision 4.4.24)
- Ambulance Safety Inspection (For vehicles older than two years) BHS/EMS-316
- Notarized Statement (Required if there is a previous owner) BHS/EMS318
- Loaner Vehicle Application BHS/EMS-182
Agency Licensing Documents
- Agency Licensing and Inspection Manual
- Flowchart for Agency Licensing Renewal
- Certificate of Insurance for Life Support Agencies BHS/EMS-0092
- Instructions for Obtaining CLIA Waiver
- Clinical Laboratory Services (CLIA Website)
- Michigan Department of Licensing and Health Administration (MIOSHA)
- MEDCOM (Revision 9.23.2020)
- Data Collection Requirements MI-EMSIS
- Vehicle Operations Course Criteria BHS/EMS-2007
- Medical Waste Information (EGLE, formerly the DEQ)
- Certificate of Need (CON) Review Standards for Air Services
Policy and Memos
- Important Safety Information Regarding Newborn Warming Mattresses (9.16.19)
- Allowable Supraglottic Airway Sizes (8.2.2022)
- Medical Waste Registration Memo (8.7.2019)
- Operating at an Increased or Decreased Level of Service (Formerly the Kievela Bill) (10.29.2019)
- Requirements for Licensure of remounted Ground Ambulances Effective 6.1.2020 (11.20.2020)
- EMS Air and Ground Out of State/Canada Mutual Aid (10.29.2021)
- Upgrade of Non Transporting Vehicles
Contact Information
Derek Flory, BAS, EMT-P / IC
Life Support Agency and Vehicle Licensing Coordinator
Phone 517-243-8205
Email: FloryD@michigan.gov