Trauma Designation

Hospital Trauma Center Designation application can now be completed online at: https://nevada.imagetrendlicense.com/lms/public/portal#/login

EMS Personnel Change of Address or Information Form

• Change of Information Form

Training Grant

• Grant Training Flyer
• Training Grant Application
• Grant Training Budget Worksheet
• Sub-Award Questionnaire

Emergency Medical Services for Children Grant

• EMSC Grant Opportunities - Pediatric Training
• EMSC Application
• EMSC Grant Budget Worksheet
• Sub-Award Questionnaire

Certification and Licensing

Attention all EMS Providers and Agencies! 

We are now accepting all applications for certification, license and renewal through the State Online Application Portal (SOAP) at https://nevada.imagetrendlicense.com/portal#/login

If your expiration date is March 31, 2020, please read this reminder thoroughly.

Please see the Renewal Instructions on how to complete your renewal application online.

To renew your certification, you will need to provide evidence that you have completed the requirements for renewal. You must upload your CPR card, continuing education units (CEUs) and a skills verification to your online renewal application. Paramedics must upload their ACLS, PALS, and ITLS or PHTLS cards in the same fashion.  If you are licensed as an Ambulance Attendant, it will also be necessary for you to renew your license when you renew your certification.

CURRENT FEE SCHEDULE

• Certification renewal - $24.00
• Certification and Attendant License renewal - $34.00
• Instructor Endorsement Renewal is an additional - $15.00
• Certification Late Renewal fee - $50.00
• Attendant License Late Renewal fee - $50.00

If you experience issues accessing your SOAP account, email the Nevada EMS office at HealthEMS@health.nv.gov and our office will assist you.

• Provisional License Application
• Skills Verification Form *online applications*
• Physician Statement *online applications*
• Instructor Hours Tracking Log
• Fingerprint Request Form *online initial license applications*

Reciprocal Certification for Out of State Providers

• Reciprocity Instructions
• Verification of Out of State EMS Certification/License Form

Nevada Shared Radio System Updates

• Nevada Shared Radio System Updates Memo
• Radio Grant Assistance Program
  • Radio System Grant Contacts Map

Agency Permit Applications and Forms

The State of Nevada EMS Office requires all permit application to be submitted online using the State Online Application Portal at:https://nevada.imagetrendlicense.com/lms/public/portal#/login

• Initial Permit Application Documents for Online Applications
  • Letter of Explanation
  • Statement of Volunteer Ambulance Service
  • Statement of Financial Worth
• Permit Renewal Application Documents for Online Applications
  • Ambulance Service Agreement Form
  • Hospital Agreement Form
  • Mechanical Safety Form
  • Verification of Current Protocols
  • Variance Review Form
  • Physician Director Agreement Form
• CLIA Disclosure of Ownership

Clinical Laboratory Improvement Amendments (CLIA)

• CLIA Website
• Application
• Instructions for Completing Disclosure of Ownership and Control-Form 1513
• Example Agency Policy
• Example Glucometer Testing Program
• Example Glucometer Testing of Staff
• Example Quality Control Log
• Example Temperature Log
• EMS Glucose Testing Checklist
• Fingerstick Devices-Technical Bulletin

NEVCORD Radio Channel

• NEVCORD Approval Letter