Mission, TX · Hidalgo County
Ambulance Service Application
Emergency medical service providers use this application to request a City of Mission license to operate an ambulance service.
What this form is
Emergency medical service providers submit this application to request a license to operate an ambulance service in the city. It asks for business and owner details, vehicle and personnel information, and attachments including insurance proof, ambulance rates, and a quality improvement program for the prior six months. The form lists a $750 permit fee plus $100.00 and a two-year permit term.
Who needs it
An emergency medical service provider seeking a City of Mission license to operate an ambulance service uses this application.
How to submit it
Make the application to the Emergency Management Coordinator or designee; the Ambulance Board reviews it and records its approval or disapproval.
About notarization
This application is signed and dated without a notary; the signer just signs and dates it.
How to submit this form
- 1
Download The Application
Download the Ambulance Service Application PDF.
- 2
Complete The Application
Provide the requested business, owner, ambulance, and personnel information.
- 3
Gather The Attachments
Attach proof of public liability insurance, ambulance rates, and the Quality Improvement Program for the prior six months.
- 4
Submit To The City
Make the application to the Emergency Management Coordinator or designee for Ambulance Board review.
Frequently asked questions
- What is the Ambulance Service Application for?
- Emergency medical service providers use it to apply for a City of Mission license to operate an ambulance service. It requests business, owner, vehicle, and personnel information.
- What attachments does the application request?
- The application asks for proof of public liability insurance, ambulance rates, and a copy of the Quality Improvement Program for the prior six months.
- Do I need a notary for the Ambulance Service Application?
- No. This application has a signature and date line but no notary block; the signer just signs and dates it.
- How do I submit the Ambulance Service Application?
- The application says to make it to the Emergency Management Coordinator or designee. The Ambulance Board reviews it and records approval or disapproval.