New Mexico Administrative Code
Title 7 - HEALTH
Chapter 27 - EMERGENCY MEDICAL SERVICES
Part 10 - CERTIFICATION OF EMERGENCY MEDICAL SERVICES AGENCIES
Section 7.27.10.21 - APPLICATION FOR CERTIFICATION
Universal Citation: 7 NM Admin Code 7.27.10.21
Current through Register Vol. 35, No. 18, September 24, 2024
A. Application. An EMS agency shall apply for certification using an approved application form, and shall provide completed and legible responses to every applicable element of the application form.
B. Application form. Applications for certification shall include at a minimum the following elements:
(1) name and contact information of
the applicant EMS agency, including at a minimum the EMS agency's mailing and
physical addresses, primary telephone number, facsimile number, and e-mail
address;
(2) name and contact
information of the applicant EMS agency's medical director, including at a
minimum the medical director's mailing address, primary telephone number,
facsimile number, and e-mail address;
(3) name and contact information of the
director or chief/chief or individual primarily responsible for the operation
of the applicant EMS agency, including at a minimum the person's mailing
address, primary telephone number, facsimile number, and e-mail
address;
(4) name and contact
information of the applicant EMS agency's dispatch center, including at a
minimum the dispatch center's mailing address, primary telephone number,
facsimile number, and e-mail address;
(5) name and contact information of the
applicant EMS agency's insurance carrier, including at a minimum the insurance
carrier's mailing address, primary telephone number, facsimile number, and
e-mail address;
(6) the county in
which the applicant EMS agency wishes to be certified, and the number of
medical rescue units operated by the applicant EMS agency; and
(7) a notarized attestation by the individual
who submits the application that certifies that the information provided in the
submitted application form is true and correct to the best of the individual's
knowledge.
Disclaimer: These regulations may not be the most recent version. New Mexico may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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