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1002 Church Hill Road, Pittsburgh, Pennsylvania 15205
Main Office Number: 412-242-7322 Main Fax: 412-787-2340
An ambulance service is required to complete this form if it intends to either replace an ambulance on a permanent basis, add an ambulance to its fleet or is required to use an ambulance on a temporary basis to replace an ambulance it has removed from service for repairs or other reasons. For a temporary ambulance, the ambulance service must submit this form to the regional EMS council that has responsibility for the EMS region in which the ambulance will be based. This form may be submitted by facsimile, electronic mail or regular mail, or any other matter no later than 24 hours after the ambulance service places the temporary ambulance in service.
This form needs to be sent to Scott Crawford (firstname.lastname@example.org) at EMSI.
|A new or additional ambulance may be used by the ambulance service only after the regional EMS council has inspected it, and the ambulance service has been authorized by the Bureau of EMS to begin using the ambulance.|
|Modification of Ambulance Fleet form.pdf||04/12/13 10:40 am||21.89 KB|