Emergency Medical System (EMS) - Permits

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 applications to be submitted online using the State Online Application Portal at:https://nevada.imagetrendlicense.com/lms/public/portal#/login. If are a new service seeking a EMS permit in Nevada, email our office at: healthems@health.nv.gov and our office will work with your agency to set up your service account in our ImageTrend licensing system.

• 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