Oregon Ambulance Forms

Forms and Applications

Renewal of an Ambulance Service and Vehicles

Service and ambulance vehicle renewal applications will be available April 1 every year. To ensure you receive your service and vehicle licenses before July, applications must be submitted by May 30.

Complete the Service License Renewal Application and the Ambulance Vehicle License Application here: eLicense log in and go to Service Applications.

Initial Ambulance Licensing

• Air Ambulance License Application
• Ground Ambulance Vehicle License Application
  

Request for Variance

Please refer to Oregon Administrative Rule (OAR) Chapter 333, Division 250 - Ambulance Service Licensing:

• Waiver or Variance from Standards OAR 333-250-0340 

   Veronica Seymour 
   veronica.seymour@oha.oregon.gov

Ambulance Service and Vehicle Survey Checklists

• Ambulance Service Facilities and Records Survey Checklist
  
• Ambulance Service Personnel File Survey Checklist
  
• Ground Ambulance Vehicle Survey Checklist
  
• Air Ambulance Vehicle Survey Checklist
  
• Air Ambulance Personnel Survey Checklist
  
• Ground Ambulance Equipment Requirements:  See OAR 333-255-0072
  
• Air Ambulance Equipment Requirements: 
  
• Air Ambulance Configuration and Life Saving Equipment Requirements OAR 333-255-0080
• Air Ambulance Operating Requirements for Interfacility Transfers OAR 333-255-0081
• Air Ambulance Operating Requirements for Scene Response OAR 333-255-0082
  

• Ground Ambulance Construction Criteria: See OAR 333-255-0060