To apply for ambulance licensure an applicant service must complete and submit the following:
1. Application for Ambulance Service Licensure;2. Roster of all proposed employees, including Emergency Vehicle Operators (EMS-Driver), EMTs, AEMTs, Paramedics, Critical Care Paramedics, RNs and Emergency Medical Dispatchers, and others if appropriate (this list must include state-issued certification and/or license numbers where applicable);3. The proposed medical control plan, including protocols (at least 30 days prior to intended service start date);4. Patient destination guidelines which comply with all state approved system of care plans and standards;5. Documentation describing communications capabilities, including capability to communicate with dispatch and primary resource hospital;6. Documentation describing the methods to be used for communicating with online medical control, conducting quality assurance and ensuring skill maintenance;7. Letter of attestation from the off-line medical director approving of the proposed medical control plan, approving of the proposed the ambulance provider's protocols, and acknowledging he/she understands his/her responsibilities as prescribed in this document (Title 15, Part 12, Subpart 31); and8. Letter of attestation from the ambulance owner acknowledging intent to provide 24/7 coverage, providing evidence of capabilities, describing staffing patterns, providing plans for backup, and listing mutual aid agreements.15 Miss. Code. R. 12-31-1.1.3