EMS Agency Renewal Submission

Welcome to the New York State Department of Health Bureau of Emergency Medical Service EMS agency renewal portal.

All renewal applications are due no less than 30 days prior to the expiration date of the agency’s operating certificate.  Ensure that all of the required documents are completed and uploaded in the appropriate section.

Please make sure that all corporate officers, including volunteer officers, Home addresses and telephone numbers are included.

Review PHL Article 30/30A to ensure compliance with all requirements. https://www.health.ny.gov/professionals/ems/art30.htm

Ensure your agency is compliant with NCRR Title 10 Part 800:

https://regs.health.ny.gov/volume-e-title-10/200443669/part-800-emergency-medical-services

To review current BEMS Policy Statements.

https://www.health.ny.gov/professionals/ems/policy/policy.htm

Should you have any questions please feel free to contact your Regional Representative:

https://www.health.ny.gov/professionals/ems/chart.htm

 

 

 

Submission Type
Name of Contact Person
Medical Director Information

Please submit an updated DOH-5136 to your Regional Program Agency, completed within the last 60 days.

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Does your agency conduct Blood Glucose (BG) testing on patients?
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Please submit an updated DOH-5136 to your Regional Program Agency, completed within the last 60 days.

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Does your agency do blood glucometry?
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Name of Contact Person
Medical Director Information

Please submit an updated DOH-5136 to your Regional Program Agency, completed within the last 60 days.

Upload requirements
Upload requirements

Please submit an updated DOH-5136 to your Regional Program Agency, completed within the last 60 days.

Upload requirements
Upload requirements