Life Support Agency & Vehicle Licensure
Effective January 1st 2020 the EMS Section will No Longer Accept Paper Applications for Agencies and Vehicles
The agency module of the eLicensing system is now active.
The module will enable Life Support Agencies (LSAs) to maintain and renew the agency license and vehicles online. Individual(s) will be given system permissions.This role in the eLicensing system will be known as an Agency Licensure Administrator. Each agency must designate the person(s) to be assigned to this role.
The following form has been sent to all agencies, and should have been returned before January 1, 2020.
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 (1-08-20)
NOTE: PDF copies of licenses will be available through Michigan EMS eLicensing Portal due to mailing delays related to COVID-19 response.
Verify EMS Agency
Forms & Publications
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.
Requirements for Licensure of Remounted Ground Ambulances Effective 6/1/20 (Updated: 3/3/20)
Medical Waste Registration Memo 8-7-19
Ambulance Operation Licensing |
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Life Support Agency Licensure and Inspection Manual
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PDF Version 1.5 (2-12-20)
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| eLicensing Public Portal Userguide | PDF Version 1 (1-02-20) |
| Flowchart for Agency Licensing Renewal | PDF (1-02-20) |
| Agency Renewal Checklist | PDF (5-11-20) |
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Certificate of Insurance for Life Support Agencies |
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Ambulance Safety Inspection (Transport ONLY) |
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Ambulance Safety Inspection - Notarized Statement (Transport ONLY) |
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Vehicle Operation Course Criteria |
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Manufacturers Certificate of Compliance (Transport ONLY) |
BHS/EMS-314 (Revision 2/28/20) |
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Data Collection Requirements
MI-EMSIS / Data Page
Loaner Vehicle Application (New or Extended Loan) |
Data Collection Requirement - MI-EMSIS
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| Medical Waste Information (EGLE, Formerly the DEQ)) | Website |
| Michigan Occupational Safety & Health Administration (MIOSHA) | Website |
CLIA InformationInstructions for obtaining CLIA Waiver PDF
Michigan Department of Licensing and Regulatory Affairs CLIA Website
Updated Equipment and Agency Requirements Effective 7-1-19Items listed under MCA Approved Equipment is only required if included in MCA protocols. Equipment Changes Memo 4-18-19 Equipment Clarifications Memo 5-2-19 Equipment Changes Spreadsheet 5-1-19 Important Safety Information Regarding Newborn Warming Mattresses 9-16-19 MFR Vehicle Minimum Equipmenmt Requirements (Updated 9-17-19) BLS Transport Minimum Equipment Requirements (Updated 9-17-19) BLS Non-Transport Minimum Equipment Requirements (Updated 9-17-19) LALS Transport Minimum Equipment Requirements (Updated 9-17-19) LALS Non-Transport Minimum Equipment Requirements (Updated 9-17-19) ALS Transport Minimum Equipment Requirements (Updated 9-17-19) ALS Non-Transport Minimum Equipment Requirements (Updated 9-17-19) Required Life Support Agency Criteria (Updated 9-4-19)
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Miscellaneous Publications |
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MEDCOM Requirements |
MEDCOM (Revision 5/20/19) |
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Certificate Of Need (CON) Review Standards For Air Ambulance Services |
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Policy
Life Support Agency Operating at an Increased or Decreased Level of Service EMS 202
Licensing Fee's for Basic Life Support, Limited Advanced Life Support, and Advanced Life Support Agencies:
Initial and renewal fee: $100.00 for the Agency License and a $25.00 fee per vehicle
Late fees are enforced if license is not renewed by the expiration renewal date: $300 for the Agency License and a $100.00 fee per vehicle
Licensing Fee's for a Medical First Responder Agency:
No Initial or renewal fees apply.
Late fees are enforced if license is not renewed by the expiration renewal date: $300 for the Agency and $100.00 fee per vehicle
Remove or Downgrade a vehicle:
No fee.
Add, Upgrade, or Replace a vehicle:
$25.00 fee per vehicle
What do I need to do to add or remove a vehicle from the Agency license?
You need to log into the Image Trend Licensing System and fill out the corresponding application.
Does my agency have to be available to provide services at all times?
Yes, all levels of licensed life support agencies need to be available to respond to emergencies 24/7.
How often do I have to renew my license?
Life support agencies renew annually.
Contact Information
Derek Flory, BAS, EMT-P / IC
Life Support Agency and Vehicle Licensing Coordinator
Phone 517-335-8382
Fax: 517-335-9434
Email: FloryD@michigan.gov
MDHHS-EMS Section
Agency/Vehicle Licensing Application
P.O. Box 30437
Lansing, Michigan 48909
Phone: 517-335-8382
Fax: 517-335-9434
